Students warned over ‘smart pills’
Experts note an alarming increase in claims for ADHD medication and caution on its abuse
AN “alarming number” of South African students are popping brain pills designed for children with attention deficit hyperactivity disorder (ADHD) — to improve their academic results.
The observation was made this week by Johannesburg psychiatrist Dr Brendan Belsham.
It came after a report in the journal Nature that the benefits of these “smart pills” were exaggerated.
Belsham addressed a Johannesburg campus where he found that “an alarming number of students in an honours” class were taking stimulants such as Ritalin or Concerta without scripts or a diagnosis.
Although local experts are divided on the extent of such abuse, it emerged that:
Children in wealthy families were being overdiagnosed with ADHD as a quick-fix solution;
The number of adults diagnosed with the disorder was rising; and
Claims for ADHD drugs from South Africa’s biggest medical aid scheme administrator had risen since 2009, from 81 587 to 149 622.
The number of Discovery Health Medical Scheme members claiming for ADHD medications roughly doubled from 2009 to 2013, from 20 176 to 39 991.
Jonathan Broomberg, CEO of the medical aid, said: “These may be an underestimation as it is possible that some members with ADHD may not submit claims for payment.”
Johannesburg psychiatrist Dr Karen Vukovic said: “Many scholars and students think it may improve cognitive function and exam scores.
“The incidence in the northern suburbs of Joburg and affluent suburbs of Cape Town and private schools is way beyond the normal population.”
She said many parents believed it was a “silver bullet”.
“Instead of changing behaviour and parenting styles, they will go and buy a pill,” said Vukovic.
Experts agree that medication combined with therapy make a big difference to children — and adults — who are professionally diagnosed.
The Nature article said that, based on US research, there was mounting evidence that ADHD medication does not make a lasting difference to school work or achievement.
Vukovic disagreed. “Many adult patients who have lived with this condition undiagnosed and who eventually go on a trial find it has a dramatic effect on their functioning.”
Dr Morwesi Mahlangu, medical ad- viser to the Attention Deficit Hyperactivity Support Group of South Africa, said: “I was a child with ADHD and now an adult with combined type ADHD. I was previously on Concerta, which helped greatly.”
She said many children had proved the medication does work and “great- ly improves self-esteem”.
Mahlangu warned that popping a pill would not perform miracles and treatment required a holistic approach and lifestyle changes.
ADHD was underdiagnosed and undertreated in children and adults in South Africa, said Johannesburg psychiatrist Dr Dora Wynchank.
“There may be some pockets where it is seemingly overdiagnosed. In certain schools, perhaps more than 7% of children are on medication. However, this would really be the exception to the rule,” she said.
The medications were safe and highly effective for both adults and children, said Wynchank.
Johannesburg psychologist Judith Ancer said ADHD might be more common today because the condition was better detected.
“The modern world creates conditions that make it harder for children to pay attention and cope in school. A child with ADHD can’t sustain effort on something seen as boring, pointless or very difficult, but could concentrate for four hours on Lego or an iPad,” she said.
The smart pills do enhance shortterm memory, alertness and concentration, but Belsham said that the jury was still out on whether the medication had long-term benefits on academic achievement.