Prescriptions of Ritalin for attention deficit hyperactivity disorder have quadrupled in a decade, prompting fears it is being pushed on children at the expense of alternative treatments and without appreciation of long-term effects.
Figures released by the NHS business services authority to the Liberal Democrat MP Tessa Munt reveal the number of prescriptions of methylphenidate hydrochloride, the generic name for Ritalin, rose in England from 158,000 in 1999 to 661,463 in 2010.
Ritalin is a psychostimulant drug most commonly approved for treatment of ADHD in children. It is also used to treat conditions such as narcolepsy and in certain cases may also be prescribed for lethargy, depression and obesity.
The Association of Educational Psychologists said its members were reporting an increase in children with behavioural difficulties being prescribed the drug in conjunction with antidepressants, despite the fact there was “little to no evidence about the effect which these cocktails of drugs are having on the development of children’s brains”.
The association claims clinical studies show the “beneficial effects of psychostimulant medication are not sustained over the long term, necessitating stronger and stronger dosages to be prescribed over time” and that it is “becoming a common practice for children to be prescribed stronger dosages than recommended in the morning as a ‘top-up’ or ‘kickstart’ dose so that medication lasts the full school day”.
Munt, who until recently sat on the education select committee, said there were natural alternatives that could help combat ADHD. She highlighted a report commissioned by the RSPB that suggested activities in a natural environment appear to improve children’s symptoms by 30% compared with urban outdoor activities, and threefold compared to playing indoors. But Munt said many young people were prevented from enjoying the outdoors because of reasons such as lack of school playing fields and the distractions posed by video games, smartphones and social networking.
“It is extremely alarming that in the decade up to 2010, prescriptions for Ritalin quadrupled,” she said. “Statistics show that 90% of prescriptions for this powerful drug in 2004 were used to combat behavioural problems in school-age children. I am shocked that there has been such a huge explosion in use.”
ADHD is believed to affect between 5% and 10% of schoolchildren in the UK. Symptoms include overactive and impulsive behaviour and difficulty paying attention. The increase in Ritalin prescriptions appears to mirror the US where there was an 83% increase in sales of the drug between 2006 and 2010.
How many children are being prescribed the drug is difficult to quantify from official data. Munt said: “Unless the Department of Health collects vital statistical data about prescribing habits, no one will know what is happening.
“We hear teachers tell of their students’ lack of ability to concentrate, from police about increasingly disruptive and antisocial behaviour, and from parents unable to control the actions of young family members. We need to show young people how to deal with the normal stresses and strains of growing up. Resorting to powerful drugs only stores up trouble for the future.”
The Association of Educational Psychologists said it believed guidelines were not being followed. The guidelines recommend that ADHD medication should not be prescribed to pre-school children for the long term.nor in isolation from other therapeutic interventions, without consultation But the association said it was aware of a substantial increase in the number of children aged under six, and in some cases as young as three, being prescribed ADHD drugs. It said an informal survey of educational psychology practitioners across the West Midlands had revealed there were more than 100 children under six on the medication in the area. “This is reaffirmed across the country by our members,” the association said.