Ritalin Prescription Fears Raised

Children with the behavioural condition ADHD are continuing to be prescribed drugs such as Ritalin, despite an ongoing investigation. BBC Scotland has learned a review of the medical guidelines used by doctors to diagnose and treat ADHD will not be available until March 2008. Parents groups and education experts have claimed children could be prescribed the medication needlessly. They have called for the review to be urgently accelerated.

There were 46,000 individual prescriptions of Ritalin in 2005 An assessment of doctors’ procedures was launched in 2004 after mounting concern over a tenfold increase in Ritalin prescription rates. Last year, 46,000 individual prescriptions were recorded in Scotland.

However, fears have been raised that children as young as four could be wrongly diagnosed with Attention Deficit Hyperactivity Disorder.

A leading education expert at Edinburgh University has warned that doctors are too keen to label children as having the condition without proper investigation into other possible causes.

Dr Gwynedd Lloyd, head of Educational Studies at the university, has expressed concern that children were needlessly being given amphetamine-based medications such as Ritalin as a result.

“I think in 10 years time we will say that ADHD was too simple an explanation for many children,” she said. “We will ask ourselves what we were thinking giving these children amphetamines.”

Children with ADHD suffer from inattention, hyperactivity and social problems. Many are unable to attend mainstream school and have problems making relationships. But treatments for the condition, such as the drug Ritalin, pose the risk of serious side effects.

These range from loss of appetite to sleeping problems and Tourette’s Syndrome. The Investigation for BBC Radio Scotland has learned that the review of the medical guidelines for diagnosing and treating ADHD will not be available until 2008.

Parents’ groups have expressed anger that the results will not be published for a further two years. They have claimed the outdated guidelines mean they cannot rely on current medical advice and face a dilemma over whether to risk putting their children onto the drugs.

Donna Miller’s son Lee was prescribed Ritalin after he was diagnosed with ADHD at the age of five. Donna, who lives in Edinburgh, found her son’s behaviour immediately worsened.

Although a boisterous “typical boy” before starting on the drugs, Lee became aggressive and violent when taking the medication. “His behaviour totally changed. He was a handful before, but on that drug he was frightening,” she said.

“The final straw was when he attacked his brother Derek. He was only five but he picked Derek up and physically threw him through a glass door.”

Donna took her son off Ritalin after six weeks due to concerns that he was a danger to the family. Dr Lloyd is concerned that other families face the risks of serious side effects.

She has called for more rigorous investigation by doctors into all aspects of a child’s life before they rush into a diagnosis of ADHD.

However, Dr Dave Coghill, senior lecturer in child and adolescent psychiatry at Dundee University, said the medication was effective. “By inhibiting impulsive behaviour in children with ADHD it allows them to socialize and develop normally,” he said.

“Despite the risks, the medication can work for some children.”

Anne Martin, who lives in Edinburgh with her son Kieran, believes that Ritalin saved her family. Kieran was diagnosed with ADHD when he started school, after teachers complained about his behaviour.

Anne said her son was difficult and recalled him destroying the house and being impossible to control. Now 13, he has been taking the drug for eight years.

“I don’t know what I would have done without it,” Anne said.

“At one point I was ready to take Kieran to the social services because I couldn’t cope anymore.

“But once he started on his medication he was like a new boy.”

The opposite experiences of Donna and Anne demonstrate the dilemma parents now face. The drugs could dramatically improve life for one child or make a bad situation much worse for another. Until the medical guidelines are reviewed and reissued, parents claim they are having to make this difficult decision alone.

The NHS told BBC Radio Scotland that the assessment would take four years to conduct. The initial stage – a scoping exercise to audit the services currently available for ADHD across Scotland – will be available in 2007.

The NHS claims there has not been a delay in the publication of the review. However, the calls to accelerate the audit have intensified after reports of potential new side effects.

Last month the United States medicines watchdog, the Federal Drugs Agency, issued its most severe advisory warning against Ritalin after 25 people were found to have died from cardiac problems.

Seven children are also thought to have died in the UK.

A spokesman for the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK said they are aware of the new US warning and intend to review their own advice for the drug.

There is currently no date for the results of the review.