A group of Quebec doctors is warning against the dangers of overprescription, saying many children in the province have been given medications for ADHD who may not need them.
The 45 physicians signed an open letter that cited data from a study showing that over an eight-year period, ADHD-related medications like Ritalin were prescribed at three times the rate in Quebec than in other provinces.
The data covered children, adolescents and adults up to the age of 25.
Attention Deficit Hyperactivity Disorder can affect a child's ability to sit still, concentrate and regulate their behaviour.
“Yes, medication can help ADHD for sure, we know that. We see the good effects of Ritalin with children who have ADHD,” said pediatrician Gilles Julien.
Julien said he was concerned about the issue, though, and that while ADHD is a valid medical condition, the medications to treat it could mask other issues that need to be investigated instead.
“They may have emotional problems, might not sleep well at home because it’s too crowded, too noisy or they don’t have enough to eat,” he said. “The child will react to that and will react frequently with impulsivity, no motivation in school, very distractible. That’s the criteria for ADHD, but it’s not ADHD. We need to assess better.”
What's required is a global solution, said Martin Gignac, chief of child psychiatry at the Montreal Children’s Hospital.
“The school system is very involved in screening those children. What can we offer them before sending them to a doctor? Can we teach them some skills so they can better regulate themselves? Can they have better access to a psycho-educator?” he said.
If follow-up with a doctor is recommended, GPs and pediatricians are equipped to assess an uncomplicated case of ADHD said Gignac, but if ADHD is combined with anxiety or learning disabilities, they need support that's not available in the public system.
“Right now our system is based mostly on private evaluation done by neuropsychologists that are very costly. So doctors in their office often receive those very complex cases and they're left with minimal resources to validate their impression,” he said.
Junior Health Minister Lionel Carmant announced a plan Thursday to hire hundreds of new professionals to help screen young children for neurodevelopmental problems.
“If we have more psychologists and more psych-educators in the network, these children can be referred to professionals rather than be given medication right away,” he said.
