Overdiagnosis of adult attention-deficit hyperactivity disorder in British Columbia has led to a surge in stimulant medication use despite limited evidence of its long-term effectiveness, according to a new publication.
The therapeutics letter, published Tuesday, notes that a reliable ADHD diagnosis is complex, with no simple diagnostic test available. Competent diagnosis requires comprehensive family, gestational and developmental history plus observations over time, such as documented symptoms from childhood or a history of substance use.
Long-term stimulant use can lead to tolerance and dependence, and some product monographs for ADHD medications warn about the potential requirement for increasing doses, physical and psychological dependence, and possible misuse, the letter said. It cited as an example the website of the ADHD medication Vyvanse, which states that the drug has a “high chance for abuse and may cause physical and psychological dependence.
“One thing that’s been raised by other experts is the idea of the impact of digital media on people’s perception of their own symptoms as inattention and impulsivity,” he said. Martin Gignac, chair of the Canadian ADHD Research Alliance and an associate professor of psychiatry at the University of Montreal, said that while the increase in diagnoses requires exploration, he disagreed with the assessment that adult ADHD is generally “overdiagnosed.” He cited 2006 research led by Harvard Medical School health care policy professor Ronald C. Kessler that estimated 4.4 per cent of U.S. adults have ADHD, with just a fraction receiving a diagnosis for it.
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