New ADHD Treatment Guidelines
Written by Faith Anderson on October 18, 2011
Prescription of Stimulant Medications for ADHD on the Rise
According to a survey published in September in the American Journal of Psychiatry, the use of stimulant medications like Adderall as a treatment for ADHD has increased in the past fifteen years, with the number of kids between the ages of thirteen and eighteen on medications rising 6.5 percent each year since 1996. Another informal survey conducted by MedPage Today a week before the new guidelines were issued indicated that nearly 80 percent of the 1,500 people surveyed believed that ADHD was over-diagnosed. “As someone who works on medication authorizations on a daily basis, I see more kids under the age of 12 receiving insane doses of ADHD meds or antidepressants, even exceeding safe FDA recommended guidelines,” said one MedPage Today reader.
According to doctors specializing in ADHD however, if the guidelines are followed correctly, it may not result in the over-medication that people fear. “The guidelines reflect what is already happening, that doctors are seeing and treating ADHD younger,” said Dr. Michael Coates, chairman of family medicine at Wake Forest University. Without guidelines like these dictating the diagnostic criteria for what is actually considered ADHD, “I would worry about looser reins on how you make diagnoses and give out medicine,” Coates said.
Behavioral Intervention Trumps ADHD Medications
Although the new guidelines recommend treatment to preschoolers, and even to those who do not meet the criteria for full-blown ADHD, the American Academy of Pediatrics advocates behavioral interventions administered by parents, teachers or mental health professionals for these patients, not medications. “This issue of overdiagnosing has people in a tither because many believe that if we diagnose we will automatically treat with medicine. That is not the case, and in fact the guidelines suggest using behavioral methods first in young children, not medicine,” said Dr. Michael Manos, head of the Center for Behavioral Health at the Cleveland Clinic.
Early Diagnosis May Mean More Effective Treatment
Previous ADHD guidelines, which were developed more than ten years ago, targeted kids between the ages of six and twelve. However, an emerging body of research suggests that it is possible to diagnose and treat the disorder beginning at age four and as late as age eighteen, according to a recent report on ADHD. “The guidelines are based on the wealth of scientific information generated in ADHD over the last two decades,” Manos reports. “The guidelines extend the age of diagnosis of ADHD primarily so we can make a difference when it is most needed – before school formally starts and before college and the work force.” According to Dr. William Pelham, director of the Center for Children and Families at the State University of New York at Buffalo, it boils down to how the guidelines are used. “If every child who gets diagnosed automatically gets medication, I would be upset with diagnostic standards that identify more children,” Pelham says. “On the other hand, if identification meant better training for parents, kids and teachers in behavioral intervention, I would be pleased at increased diagnostic prevalence.”