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May 1996, Vol 150, No. 5 >
Article | May 1996

The Use of Methylphenidate in Michigan FREE

Gerald Kaufman, PhD; Anthony Malone, MD
Arch Pediatr Adolesc Med. 1996;150(5):558. doi:10.1001/archpedi.1996.02170300112029.
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The results reported in the article by Rappley et al1 in the June 1995 issue of the Archives are misleading regarding the extent of attention-deficit hyperactive disorder (ADHD) in Michigan. They underestimate what appears to be a major "epidemic" and/or large-scale overdiagnosing of ADHD.

The method used to determine ADHD is based on an analysis of only 2 months of prescribing methylphenidate hydrochloride. As indicated in a literature review, Sherman and Hertzig2 found that more than half of all methylphenidate prescriptions written during 1986 in New York were for 1 prescription per child per year. If Michigan's prescribing was similar to New York's, and 50% of the patients received only 1 methylphenidate prescription per year, the authors could have missed 42% of the patients diagnosed and treated for ADHD during 1 year from this factor alone, besides missing other patients receiving more than 1 prescription in 1 year

REFERENCES

1 +
Rappley MD, Gardiner JC, Jetton JR, Houang RT.  The use of methylphenidate in Michigan . Arch Pediatr Adolesc Med . 1995;;149:675-679.
2 +
Sherman M, Hertzig M.  Prescribing practices of Ritalin: the Suffolk County, New York study . In: Greenhill L, Osman B, eds. Ritalin Theory and Management . New York, NY: Mary Ann Liebert Inc; 1991;:187-193.
3 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Association; 1994;.
4 +
Drug Enforcement Administration. Diversion Quarterly . Washington, DC; US Dept of Justice: 1994;;1:4-6.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Rappley MD, Gardiner JC, Jetton JR, Houang RT.  The use of methylphenidate in Michigan . Arch Pediatr Adolesc Med . 1995;;149:675-679.
2 +
Sherman M, Hertzig M.  Prescribing practices of Ritalin: the Suffolk County, New York study . In: Greenhill L, Osman B, eds. Ritalin Theory and Management . New York, NY: Mary Ann Liebert Inc; 1991;:187-193.
3 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Association; 1994;.
4 +
Drug Enforcement Administration. Diversion Quarterly . Washington, DC; US Dept of Justice: 1994;;1:4-6.

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