Pubdate: Tue, 14 Dec 1999 Source: Reuters Copyright: 1999 Reuters Limited. Author: Not Specified DOCTOR VISITS BY YOUNGSTERS WITH ADHD UP 90% NEW YORK, Dec 14 (Reuters Health) -- The number of doctor visits made by youngsters diagnosed with attention-deficit/hyperactivity disorder (ADHD) increased by 90% between 1989 and 1996, and three-quarters of those visits involved drug treatment, according to a report published in the December issue of the Archives of Pediatrics and Adolescent Medicine. Dr. Julie Magno Zito of the University of Maryland in Baltimore led a team of researchers in analyzing data from the National Ambulatory Medical Care Survey, looking at visits for ADHD made by children aged 5 to 14, and at prescription patterns for these visits. The proportion of youth visits to physicians that were for ADHD increased steadily from 1989 to 1996, and so did the number of visits that involved drug treatments. For example, the proportion of ADHD youth visits that involved prescription for stimulants increased from 62% to 77%. About 61% of ADHD visits were made to primary care providers, about 25% to psychiatrists, and about 8% to neurologists. The investigators found significant differences in prescribing patterns according to specialty: primary care doctors were more likely to prescribe stimulants alone, while psychiatrists were more likely to prescribe other psychotherapeutic drugs either alone or in combination with stimulants. Zito and colleagues note that the standard therapy for ADHD is stimulants, and over 80% of ADHD visits that involved medications involved just those. But about 8% of medication-related visits involved other drugs instead of stimulants, and about 10% involved both. Youngsters receiving ''more complex'' drug therapy were more likely to have depression or behavior disorders than those children given only stimulants. The nonstandard drugs most often given to children with ADHD were antidepressants, clonidine, and antipsychotics. The authors suggest that their findings should be used to guide systematic research evaluating different therapies for different groups of ADHD patients. Writing in an editorial in the same issue, Dr. Mark L. Wolraich of Vanderbilt University in Nashville, Tennessee, agrees. ``In the future, we will need to demonstrate that the treatments make a difference in how the children behave,'' Wolraich states. ``As Zito and her colleagues point out, until we are better able to address practice questions, it will be difficult for us to provide realistic and effective practice guidelines and we will not be able to answer the continuing public concern about to what extent is current stimulant medication use appropriate,'' Wolraich concludes. SOURCE: Archives of Pediatrics and Adolescent Medicine 1999;153:1257-1263, 1220-1221. or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. - --- MAP posted-by: allan wilkinson