Family doctors face pressure to prescribe ADHD drugs

Family doctors say they are coming under increasing pressure from parents to send their children for ADHD tests, even though the doctors do not think it is necessary, according to research by Groningen teaching hospital and youth care organisation Accare.

A survey of 900 doctors, which was part of the research, showed that nine out of 10 family doctors have felt pressurised by parents and schools to prescribe the medication for children who don’t have the disorder.

Some 34% of family doctors said they had given in to parents and prescribed the medication when they felt it was not necessary, and 17% said they had caved in to requests from schools.

Some 73% of family doctors said they think Ritalin is prescribed too early.

Groningen PhD candidate Anne-Flore Matthijssen, who followed a group of children using ADHD medication for over two years, also found that 60% of children who were weaned off the medication showed no difference in behaviour.

Methylphenidate, the active ingredient in Ritalin and similar medication, is effective in treating ADHD, Matthijssen said, but no research has been done into its long-term effects.

Current guidelines recommend children stop taking the medicine for a week after every year to gauge effectiveness but according to Matthijssen children could stop taking the medication altogether after a longer period of use.

“More children are being treated with methyphenidate for longer periods and now we know it no longer works in some children after a time. Perhaps more children could stop taking the medication in the long term. That option needs to be considered,” she told broadcaster NOS.

Some 5% of children in the Netherlands have been diagnosed with ADHD, which is characterised by a lack of concentration and impulsive hyperactive behaviour. Family doctors can diagnose the condition and prescribe medication but most say this is happening too early. Methylphenidate can cause sleeplessness, lack of appetite and growth delay in young children.

“Young children are like puppies, they are always active. But society expects them to sit still, listen and do little task from a young age,” family doctor Mai Neijens told the broadcaster.

The emphasis is on cognitive development to the detriment of the child’s physical needs. “Some active children can’t do what we ask of them. They don’t have ADHD, they are just healthy children,” she said.

Prescriptions for ADHD medication, such as Ritalin, Concerta and Medikinet quadrupled in the years between 2003 and 2014. In 2023, some form of methylphenidate was prescribed 85,000 times for children aged between 4 and 17.

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