Parents giving ADHD drugs to preschoolers more often; off-label misuse causing concern
Published: 01 Oct. 2025, 18:51
![The photo shows an English kindergarten in Gangnam District, southern Seoul on March 13. [YONHAP]](https://koreajoongangdaily.joins.com/data/photo/2025/10/01/ab4bbb92-335e-41d8-89b9-f97315fdf1c2.jpg)
The photo shows an English kindergarten in Gangnam District, southern Seoul on March 13. [YONHAP]
More than 10,000 pills used to treat attention deficit hyperactivity disorder (ADHD) have been prescribed each year to children under the age of 5, raising concerns that the so-called “study drugs” are spreading beyond teenagers to preschoolers.
A total of 38,456 pills of methylphenidate — the main ADHD medication — were prescribed to infants and toddlers aged 0 to 4 between 2022 and 2024, according to data by the Ministry of Food and Drug Safety and the Health Insurance Review and Assessment Service that Rep. Suh Myung-ok of the conservative People Power Party released on Wednesday.
The annual breakdown shows 415 prescriptions totaling 13,844 pills in 2022, 345 prescriptions totaling 11,729 in 2023 and 276 prescriptions totaling 12,883 in 2024 — around 12,000 prescriptions every year.
A large portion of those prescriptions appear to have been off-label and paid out of pocket. Between 70 and 80 percent — 323 cases in 2022, 249 in 2023 and 228 in 2024 — were issued without an official ADHD diagnosis, suggesting widespread non-reimbursed prescribing.
Prescriptions for children ages 5 to 9 have also risen sharply. The number of cases increased 39 percent in three years, from 254,871 in 2022 to 354,342 in 2024. The number of pills prescribed surged 55 percent, from 8.44 million to 13.1 million. Over the past three years, 32.7 million pills were prescribed in total for this age group, with about 20 percent of a total of around 930,000 cases being off-label.
Medical experts are particularly alarmed by off-label use in preschoolers. The most widely prescribed ADHD medication last year, Concerta OROS, is not approved for children under 5 due to insufficient evidence of safety and efficacy. Other commonly used drugs, including Medikinet Retard and Penid, are also only recommended for ages 6 and older.
“It appears that prescriptions are being written by general clinics at the request of parents, rather than by child psychiatry specialists,” said a medical industry source.
![The photo shows an English kindergarten in Gangnam District, southern Seoul on March 13. [YONHAP]](https://koreajoongangdaily.joins.com/data/photo/2025/10/01/8d86dcc2-8a4f-4b87-bb26-b34ffcc0a170.jpg)
The photo shows an English kindergarten in Gangnam District, southern Seoul on March 13. [YONHAP]
The trend reflects Korea’s overheated early-education culture, with terms like “age 4 decree” and “age 7 decree” coined to describe academic pressure.
“Many moms are considering prescriptions because they hear it helps kids concentrate for a while,” said Kim, a mother in her 30s who sends her 5-year-old daughter to education hub Daechi-dong in southern Seoul. Another parent of a 5-year-old recently posted on a parenting forum that a developmental center had recommended ADHD medication for their child.
“If prescribed for treatment, it cannot be covered as an off-label case, which means these drugs are being misused among preschoolers,” said a pharmacist.
Shin Yee-jin, a professor of child psychiatry at Severance Children’s Hospital, stressed that hyperactivity in early childhood is difficult to diagnose, test accuracy is low and medication safety has not been proven.
“Parental guidance and behavioral therapy must come first — there is absolutely no justification for forcing children to sit still by giving them drugs,” she said.
“There must be a thorough review of whether controlled substances are being excessively prescribed through off-label channels,” said Rep. Suh. “It is very concerning that unproven medications are being given to preschoolers. The government must urgently investigate and introduce measures to curb drug misuse fueled by the early-education craze.”
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
BY CHAE HYE-SEON [[email protected]]
with the Korea JoongAng Daily
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