ADHD Narcotic Medications Prescribed to 964 Children Under Age 6 Over Three Years

Approved Use and Safety Guidelines Restrict to Ages Six and Older
No Age Criteria in Drug Abuse Monitoring Standards
Seo Mihwa: "Prescription Appropriateness Must Be Scrutinized Closely"

It has been found that medical narcotic drugs for treating Attention Deficit Hyperactivity Disorder (ADHD), which are only approved for use in children aged six and older, have been prescribed to 964 children under the age of six over the past three years. Prescriptions among school-age adolescents are also rapidly increasing, which has led to calls for more rigorous management of prescription appropriateness according to age.

According to materials submitted to the Health and Welfare Committee of the National Assembly by Assemblywoman Seo Mihwa of the Democratic Party of Korea, as released by the Ministry of Food and Drug Safety on September 28, the number of patients under the age of six who were prescribed methylphenidate amounted to 426 in 2023, 324 in 2024, and 214 in 2025. The number of prescriptions also declined from 2,287 to 1,575 and then 1,061 over the same period.

However, last year, 214 children under the age of six received methylphenidate prescriptions. By age group, this included 4 children aged three, 18 aged four, and 192 aged five. Notably, prescriptions to five-year-olds accounted for 819 recipients over the last three years, or 85.0% of the total.

Methylphenidate is a psychotropic drug with stimulant effects and is regulated as a medical narcotic. In Korea, the product is only approved for those aged six and older. The Ministry of Food and Drug Safety’s "Safety Use Guidelines for Medical Narcotic ADHD Treatment Drugs," established in 2022, also stipulate that use is limited to children aged six and over and adults who have been diagnosed with ADHD. The United States Food and Drug Administration (FDA) announced a safety warning in June of last year that children under six taking extended-release methylphenidate formulations may have a greater risk of adverse reactions, such as weight loss, and went on to update product information in September of the same year.

The problem is that the Ministry of Food and Drug Safety’s monitoring system for medical narcotic abuse does not include an age criterion. Currently, the "Abuse Prevention Measures Criteria" includes cases such as prescriptions exceeding three months, prescriptions for non-treatment purposes, and prescriptions exceeding the maximum daily dosage. However, prescriptions to children under six are not explicitly stipulated as a separate criterion.

The Ministry of Food and Drug Safety explained that, apart from the general abuse prevention criteria, it notifies doctors found to have prescribed the medication to children under six and checks the reasons for these prescriptions. The ministry further stated that a research project to supplement the criteria for prescriptions to children under six also began this year. This move comes four years after specifying "six years and older" in the safety use guidelines.

The rate of prescriptions among adolescents is also increasing sharply. The number of methylphenidate prescriptions for patients aged 18 and under rose from 119,205 in 2023 to 145,216 in 2024 and 169,274 in 2025—a 42.0% increase over two years.

The increase was particularly marked among those aged 13 to 18. In this age group, prescription recipients grew from 47,285 in 2023 to 76,838 last year, representing a 62.5% jump. For those aged 17, the increase was 70.3%, and for 18-year-olds, it was 82.3%. Although methylphenidate is used for ADHD treatment, concerns over misuse among teens have persisted, as it is widely but incorrectly believed to enhance academic performance as a so-called "study drug."

Regarding the recent increase in prescriptions, the Ministry of Food and Drug Safety explained, "Since the ADHD diagnostic criteria became clearer in 2022, the number of patients itself has risen." However, concerns remain that methylphenidate, as a medical narcotic, continues to be prescribed to children under the approved age and to school-age adolescents at a rapidly increasing rate, underscoring calls for more meticulous monitoring of prescription appropriateness by age group.

Assemblywoman Seo Mihwa emphasized, "Because methylphenidate is a medical narcotic, it should only be used appropriately in patients who truly need it. The Ministry of Food and Drug Safety must thoroughly verify whether prescriptions for children under six—below the approved age—and for adolescents, whose prescription rates are soaring during their school years, are appropriate. The ministry should also expedite the completion of research to supplement the prescription criteria for those under six and incorporate this into abuse monitoring standards."

This content was produced with the assistance of AI translation services.