Avoid giving healthy patients ADD drugs, MDS advised

TORONTO — Doctors should think twice about prescribing drugs like Ritalin and Adderall used to treat attention deficit disorder to healthy individuals seeking to boost their brain power, says an article in the Canadian Medical Association Journal.

The authors say prescription stimulants are used by some people for cognitive enhancement in the absence of any medical need.

“These would be any types of medications that would help people enhance their concentration, memory, cognitive function in general, when they don’t necessarily have any type of symptom or illness to be treated with these medications,” said lead author Cynthia Forlini, a PhD candidate in neuroethics at McGill University.

“So we’re talking about healthy individuals who are approaching their doctors for some kind of an edge in their performance,” she said Monday.

There is little data in Canada on how widespread the practice is, but some studies suggest that between one per cent and 11 per cent of university students take cognitive-enhancing medications, obtaining them through peers or black market channels.

“So we can’t say exactly how big of a problem this is, but it is nonetheless something that needs to be considered from a physician’s point of view.”

Forlini and her co-authors argue there are several reasons why doctors should avoid prescribing ADD drugs to patients who don’t have symptoms of attention deficit disorder or related conditions.

For one, it’s unclear whether the medications confer any benefit — and their side-effects may cause harm.

“There isn’t a lot of evidence to suggest that these medications actually work for healthy individuals,” she said, noting that while some studies have shown modest effects, much of the evidence has been anecdotal.

“But there’s no kind of resounding call to say this is something that is supported by scientific data.”

Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto, said the potential harms associated with the drugs are important for doctors — and patients — to consider.

“For the most part, these drugs are chemically similar to amphetamines and ... these drugs are expected to share some side-effects with amphetamines,” he said.