The Kid’s Doctor: So-called ‘good grades pill’ an unnecessary and potentially harmful stimulant

By Sue Hubbard, M.D.
 
 There’s a lot of pressure placed on students to succeed, and many of them are turning to what teens call the “good grades pill.” What is it? One of the prescription stimulants commonly prescribed to treat children with Attention Deficit Hyperactivity Disorder (ADHD). Some teens who haven’t been diagnosed with ADHD have figured out that with the help of such drugs, they can focus better and improve their grades. 
 
  I see a lot of kids with attentional issues, and I evaluate and treat children for ADHD. That being said, I also spend a great deal of time with each family looking at their child’s history, report cards, teacher comments, educational testing and subjective ADHD rating scales.
 
  While many families would like it if I just “wrote a script for a stimulant,” I feel it’s my job to try and determine, to the best of my ability, which children really fit the diagnosis of ADHD. There are specific criteria for diagnosing this disorder. 
 
  However, in the last 3 to 5 years, more and more teenage patients have been coming to me, complaining of “having ADHD.” These are successful teens who are now in competitive schools. In most cases, the teens have never had any previous complaints about difficulty focusing or inattentiveness. All are typically A and B students, but are now having to work harder to keep their grades up and keep pace with all their extracurricular activities. They all want to go to “great colleges” and their parents expect that of them, as well.
 
  When I see these teens, I point out to them that they made no mention of school difficulties throughout their elementary and middle school years. I also tell them that ADHD symptoms, by definition, are typically evident by the time a child is 7, and often earlier. I don’t take out the script pad.
 
  I believe that stimulant medications are effective when used appropriately. I’m also well aware that these drugs are overprescribed and are being abused. I’ve had parents (and their children) be quite upset with me when I decline to write a prescription for stimulant medication for a teen. 
 
  I think this problem is growing. We parents need to stop pressuring our children, and (we) doctors need to be vigilant in deciding when stimulant medications are appropriate.
 
  Drug use can be a slippery slope. Sadly, the number of teens obtaining stimulants illegally is on the rise. While many young people may believe drugs will help their grades in the short term, what does their long-term future look like?
 
Dr. Sue Hubbard is a nationally known pediatrician and co-host of “The Kid’s Doctor” radio show. Submit questions at www.kidsdr.com
 
This was printed in the February 10, 2013 – February 23, 2013 Edition