American Academy of Neurology study: Doctors cautioned against using drugs to treat children

19 Mar

Moi wrote in More children now on antipsychotics drugs:

Duff Wilson chronicles one family’s harrowing ordeal as they sought first, an accurate diagnosis and then appropriate treatment for their child. In the New York Times article, Child’s Ordeal Shows the Risk of Psychosis Drugs For The Young Wilson reports about the Warren family. Judy Lightfoot has a very informative article at Crosscut, We’re Doing Experiments On Poor Children whose are prescribed antipsychotic drugs more often. Pamela Paul has a fascinating article in the New York Times about preschoolers and depression. In the article, Can Preschoolers Be Depressed? Paul does a great job of describing what depression looks like in small children and reporting about nascent research efforts by various universities.                                                                                   https://drwilda.com/2012/08/10/more-children-now-on-antipsychotics-drugs/

The American Academy of Neurology (AAN), the world’s largest professional association of neurologists, is releasing a position paper on how the practice of prescribing drugs to boost cognitive function, or memory and thinking abilities, in healthy children and teens is misguided.”

Genevra Pittman of Reuters writes in the article, Be cautious of mind-altering drugs for kids: doctors:

Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.

Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.

According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.

Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.

“What we’re saying is that because of the volume of drugs and the incredible increase… the possibility of overdiagnosis and overtreatment is clearly there,” said Graf, from Yale University in New Haven, Connecticut.

In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents’ advice.

Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.

http://www.reuters.com/article/2013/03/13/us-medications-kids-idUSBRE92C17H20130313

Here is the press release from the American Academy of Neurology:

FOR IMMEDIATE RELEASE, MARCH 13, 2013

AAN: Doctors Caution Against Prescribing Attention-Boosting Drugs for Healthy Kids

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MINNEAPOLIS – The American Academy of Neurology (AAN), the world’s largest professional association of neurologists, is releasing a position paper on how the practice of prescribing drugs to boost cognitive function, or memory and thinking abilities, in healthy children and teens is misguided. The statement is published in the March 13, 2013, online issue of Neurology, the medical journal of the American Academy of Neurology.

This growing trend, in which teens use “study drugs” before tests and parents request ADHD drugs for kids who don’t meet the criteria for the disorder, has made headlines recently in the United States. The Academy has spent the past several years analyzing all of the available research and ethical issues to develop this official position paper.

Doctors caring for children and teens have a professional obligation to always protect the best interests of the child, to protect vulnerable populations, and prevent the misuse of medication,” said author William Graf, MD, of Yale University in New Haven, Conn., and a member of the American Academy of Neurology. “The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable.”

The statement provides evidence that points to dozens of ethical, legal, social and developmental reasons why prescribing mind-enhancing drugs, such as those for ADHD, for healthy people is viewed differently in children and adolescents than it would be in functional, independent adults with full decision-making capacities. The Academy has a separate position statement that addresses the use of neuroenhancements in adults.

The article notes many reasons against prescribing neuroenhancement including: the child’s best interest; the long-term health and safety of neuroenhancements, which has not been studied in children; kids and teens may lack complete decision-making capacities while their cognitive skills, emotional abilities and mature judgments are still developing; maintaining doctor-patient trust; and the risks of over-medication and dependency.

The physician should talk to the child about the request, as it may reflect other medical, social or psychological motivations such as anxiety, depression or insomnia. There are alternatives to neuroenhancements available, including maintaining good sleep, nutrition, study habits and exercise regimens,” said Graf.

The statement had no industry sponsors.

View the full statement at: http://neurology.org/lookup/doi/10.1212/WNL.0b013e318289703b. View the AAN’s full statement on neuroenhancements and adults at: http://www.neurology.org/content/early/2009/09/23/WNL.0b013e3181beecfe.full.pdf

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy. For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Parents must be advocates for their children. If the first medical opinion does not seem right, get a second or even a third opinion.

Related:

Schools have to deal with depressed and troubled children https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’ https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

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