Seeking straight A's, parents push for pills

A 2004 rat study conducted by the National Institutes of Health and McLean Hospital/Harvard Medical School suggested that children who take prescription drugs for ADHD but do not have the disorder may be at higher risk for developing depressive symptoms in adulthood. The study was particularly looking at the issue of misdiagnosis but it raises obvious concerns for the future of young people who are electing to take the medicine for no other reason than to do well in school.

In addition, Yates says that possible dependency issues, either psychological or physical, could occur when the drugs are being misused. It’s widely acknowledged that some kids abuse the drugs to get high. The pills are often crushed and snorted or even injected.

Searching out other explanations
While ADHD drugs aren't a quick fix for a lackluster report card, Stein says that poor academic performance is cause for investigation — sometimes for ADHD but also for a host of other problems. “If it was brought to my attention that someone’s grades were going down even to B's I would start looking at the whole picture," he says.

Stein says there are a variety of learning disabilities and myriad situations that are not medical but still may have an impact on a child’s academic performance.

“It could also be something situational like a divorce or a relationship with another person this kid is having," he says. "It could be that a parent has lost a job and there’s financial stress in the family.”

Depression, anxiety and other mental disorders might also be at work.

“ADHD is only one of the possibilities, and I make a point to put that at the end,” says Stein. 

Perrin says he’s particularly skeptical when he’s treated a patient for many years and attention problems are only brought up once the child reaches high school. The 15-year-old girl in question, for example, had been his patient for more than a decade. He concluded that she was just a normal teen experiencing the distractions — sports, boys, friends — that teens experience.

He said that even if he had ultimately determined that the girl had ADHD, medication would not have been a speedy remedy. “True ADHD is not something that is dealt with quickly,” he says.

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Scrupulous doctors, Perrin says, will take numerous office visits and much investigation before diagnosing the problem. And, if ADHD is diagnosed, they will not just prescribe medication. They’ll also prescribe behavioral therapy (sometimes for the entire family) and recommend fairly significant changes in the child’s home and learning environment.

Furthermore, doctors warn that if a kid doesn’t have ADHD, the benefit from taking the drugs is unpredictable and, despite the lore, most likely extremely modest. Parents of unmotivated kids may be particularly disappointed.

“One of the biggest problems in adolescent mental health is motivation,” says Rater. “And this medication doesn’t effect motivation. If a kid is not all that motivated, it’s really not going to help.”

Victoria Clayton is a freelance writer based in California and co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.

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