Physicians have an ethical responsibility to avoid the practice of providing prescription medication to boost mental performance of otherwise healthy kids and teens.
Neuroenhancement — the use of prescription medication by healthy persons for the purpose of augmenting normal cognitive or affective function — “in legally and developmentally nonautonomous children and adolescents without a diagnosis of a neurologic disorder is not justifiable,” according to the authors of a position paper published in the March 13, 2013, online issue of Neurology.
As mild attention-deficit/hyperactivity disorder (ADHD) has become more prevalent, so has the 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.
“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.
A June 2012 study in Pediatrics found the number of ADHD drug prescriptions for children under 17 climbed 46 percent from 2002 to 2012, according to CBS News.
Physicians need to consider the possibility that requests by patients or parents for neuroenhancement may reflect other non-medical motivations or concerns. The statement suggests physicians use a “pediatric patient-centered interview using open-ended questions may elicit signs of anxiety, depression, insomnia, coercion, bullying, fear of school failure, an excessive need for social recognition, or pressure for higher academic achievement.” Some of the recommendations include:
- Physicians should inquire about the child’s natural talents and relative weaknesses
- Ascertain the family’s expectations of neuroenhancement
- Explore any direct or indirect coercion by peers, family or teachers for neuroenhancement
- Consider the need for additional testing and referrals before diagnostic conclusions and therapeutic recommendations can be made
- Consider the legal implications and potentially life-threatening health consequences of unnecessarily prescribing neuroenhancement drugs
“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 full statement can be found here.