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British Health Agency Discourages Ritalin Use

September 26, 2008 05:16 PM
by Denis Cummings
Britain’s national health institute has recommended that doctors minimize the use of drugs like Ritalin to combat ADHD, advising that psychological therapy be used instead.

‘An Over-Reliance on Medicines’

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The National Institute for Health and Clinical Excellence (NICE), an agency that works closely with Britain’s National Health Service (NHS), announced that its 2009 guidelines will ask doctors to curb the use of drugs like Ritalin and stop prescribing it to children under the age of 5.

Ritalin is a popular brand of methylphenidate, a stimulant drug that is also sold under the name of Concerta. Methylphenidate and atomoxetine (sold as Strattera) are the drugs most commonly prescribed to children and adults with attention deficit hyperactivity disorder (ADHD).

NICE found that the drugs are overprescribed to children who suffer from a mild form of ADHD or who may just be overactive. Fewer than 3 percent of British children have ADHD, and only one-third of those diagnosed children have a severe form that necessitates the use of drugs. However, in some towns, as many as one in seven children under 16 are prescribed Ritalin.

The drugs have been shown to significantly improve the attentiveness and productivity of ADHD sufferers, so much so that even some without ADHD take it to improve their performance at work and in school. They are quick, effective and considered the easiest fix for calming active children, leading to a large rise in prescriptions over the last decade.

“The explosion in diagnosis of ADHD, and in the prescribing of Ritalin, implies an unconscious contract of convenience between over-pressed doctors, frustrated parents and teachers who can’t cope,” writes neuroscience professor Colin Blakemore in the Daily Telegraph.
Though the drugs are effective, there are many side effects and there has been little research into their long-term effects. “Stimulants such as Ritalin raise the levels of various chemicals in the brain, especially dopamine, which is involved in emotion, the control of movement and concentration,” writes Blakemore. “Ritalin has powerful effects on the brain, and we need to know much more about the long-term consequences of its use by young children before it can be so widely condoned.”

NICE advises that ADHD sufferers get psychological therapy, and parents and teachers receive training on how to deal with ADHD children. If these techniques are not effective, then drugs should be considered, it suggests.

However, there is a shortage of classes and training. Parents of ADHD children already face long waits, which will almost certainly become longer as parents follow the advice of NICE. “There are huge waiting lists, and many training programmes are not ADHD-specific and they’re useless,” says Andrea Bilbow, founder of the Attention Deficit Disorder Information and Support Service, an ADHD charity.

As an advising agency to the NHS, NICE has been known to reject successful treatments and drugs based on cost-effectiveness. However, here it is advocating a far more expensive and time-consuming treatment, and neither NICE nor the NHS has provided a specific plan for increasing the availability of therapy.

“This needs to be backed by better resources,” said Bilbow. “Lots of the good programmes are delivered by the voluntary sector, but the problem is, who funds them?”

Reference: ADHD guide

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