No attention-boosting drugs for healthy kids, doctors urge

Friday, 15 March 2013

Doctors at Yale School of Medicine and the American Academy of Neurology (AAN) have called upon their fellow physicians to limit or end the practice of prescribing memory-enhancing drugs to healthy children whose brains are still developing. Their position statement is published in the March online issue of the journal Neurology, the medical journal of the AAN.

The statement was written to address the growing trend in which teens use "study drugs" before tests and parents request attention deficit hyperactivity disorder (ADHD) drugs for children who don't meet the criteria for the disorder. The AAN spent several years analyzing all of the available research and ethical issues to develop this official position statement on the topic.

"Doctors caring for children and teens have a professional obligation to always protect the best interests of the child, to protect vulnerable populations, and to prevent the misuse of medication," said first author of the statement, William Graf, M.D., professor of pediatrics and neurology at Yale School of Medicine. "The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable."

Graf and a group of child neurologists provide evidence that points to dozens of ethical, legal, social, and developmental reasons why prescribing mind-enhancing drugs, such as those used to treat ADHD, for healthy people is viewed differently in children and adolescents than it would be in functional, independent adults with full decision-making capacities.

Some of the reasons not to prescribe neuroenhancements include: 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 judgments and cognitive abilities are still developing; maintaining doctor-patient trust; and the risks of over-medication and dependency.

"A 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," said Graf, who notes that there are alternatives to neuroenhancements available, including maintaining good sleep, nutrition, study habits, and exercise regimens.

Other authors on the position statement include Saskia K. Nagel, Leon G. Epstein, M.D., Geoffrey Miller, M.D., Ruth Nass, M.D., and Dan Larriviere, M.D.