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Panel Calls for More Caution in Diagnosing, Treating ADD

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An international drug-monitoring group has called for more caution in how attention-deficit disorder is diagnosed and treated.

The International Narcotics Control Board, which is financed by the United Nations, also called for the World Health Organization to evaluate ADD's prevalence in various countries, the criteria used to diagnose the disorder, and the use of stimulant medications as a treatment.

The Vienna-based board, a 13-member independent panel that includes doctors, business leaders, diplomats, and others, late last month issued its yearly report analyzing the world's supply of legal and illegal drugs and monitoring compliance with international drug-control treaties. In that 70-page report, three pages discussed the use of the stimulant drug methylphenidate, which is used to treat ADD.

Children with ADD are unable to concentrate, and, in many cases, are impulsive and hyperactive. The report says an estimated 3 percent to 5 percent of U.S. schoolchildren are taking the drug, a controlled substance commonly known by the brand name Ritalin.

Both ADD and Ritalin have come under increased scrutiny as more children are diagnosed with the disorder. Some educators and doctors fear that ADD is overdiagnosed, and the board's report underscores that concern. (See Education Week, Feb. 22, 1995.)

"The board requests all governments to exercise the utmost vigilance in order to prevent 'overdiagnosing' of ADD in children and medically unjustified treatment with methylphenidate and other stimulants," it says.

Methylphenidate production worldwide increased from less than 3 tons in 1990 to more than 8.5 tons in 1994 and continues to rise, the report says. And while the drug's use in other countries has increased, the United States accounts for roughly 90 percent of the world's production and consumption of methylphenidate, the report says.

--Lynn Schnaiberg

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