The American Academy of Neurology (AAN), the world's largest professional association of neurologists, is releasing a position paper on how the practice of prescribing drugs to boost cognitive function, or memory and thinking abilities, in healthy children and teens is misguided.
The statement is published in the March 13, 2013, online issue of Neurology, the medical journal of the American Academy of Neurology.
This 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, has made headlines recently in the United States. The Academy has spent the past several years analyzing all of the available research and ethical issues to develop this official position paper.
"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. "The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable."
The statement provides evidence that points to dozens of ethical, legal, social and developmental reasons why prescribing mind-enhancing drugs, such as those for ADHD, for healthy people is viewed differently in children and adolescents than it would be in functional, independent adults with full decision-making capacities. The Academy has a separate position statement that addresses the use of neuroenhancements in adults.
The article notes many reasons against prescribing neuroenhancement including: the child's best interest; the long-term health and safety of neuroenhancements, which has not been studied in children; kids and teens may lack complete decision-making capacities while their cognitive skills, emotional abilities and mature judgments are still developing; maintaining doctor-patient trust; and the risks of over-medication and dependency.
"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 statement had no industry sponsors.
- William D. Graf, Saskia K. Nagel, Leon G. Epstein, Geoffrey Miller, Ruth Nass, and Dan Larriviere. Pediatric neuroenhancement Ethical, legal, social, and neurodevelopmental implications. Neurology, 2013 DOI: 10.1212/WNL.0b013e318289703b
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