Empirical, ethical, and political perspectives on the use of methylphenidate.

The case for methylphenidate (MPH) (Ritalin) rests on claims that Attention Deficit Hyperactivity Disorder (ADHD) is a disorder, that ADHD is biologically rooted, that MPH is effective against ADHD, that nontreatment is developmentally hazardous, and that MPH is a relatively innocuous rather than dangerous treatment. It will be found that the case for MPH rests on the hope that ADHD is a biological disorder and on MPH's short-term suppression of disruptive behavior. The explosion of MPH use on this flimsy evidential base can be explained within a political economy analysis but is difficult to justify ethically. It suggests a disturbing reliance upon drugs to solve problems stemming from a combination of inadequate support for families in modern societies and educational systems pushed to do more with less. Reliance upon a psychoactive medication to make children "ready to learn" is not only unsupported by the evidence, it teaches children incorrect lessons about how to meet the stresses and challenges of life.