• Tenfold increase in prescription of Ritalin sparks enquiry
• 'Chemical cosh' given to children to combat hyperactivity
• Opponnets argue it is a Class A amphetamine with damaging side effects
Key quote"It’s important to [ensure] that
children who have this condition are diagnosed early on and treated properly. The variation in the treatment throws up the question, ‘Is there a problem here?’ Therefore, we will conduct an audit."
- LORD NAREN PATEL, CHAIRMAN, QISStory in full AN INQUIRY was ordered yesterday after a tenfold increase in the number of prescriptions of the behaviour-controlling drug Ritalin issued by GPs to treat hyperactive children.
In 1996, there were 69 prescriptions per 10,000 children aged between four and 16 - by last year, that had jumped to 603 per 10,000.
Ritalin - known as the "chemical cosh" - is given to children with attention-deficit hyperactivity disorder (ADHD) and there are growing fears that it can cause long-term damage.
The inquiry, ordered by the National Health Service’s own watchdog, Quality Improvement Scotland (QIS), will focus on why some health authorities appear to be prescribing considerably higher amounts of the drug than others.
It is thought about 16,500 children a year are now put on Ritalin by their GPs. Parents who claim their children have been dramatically affected by the drug complain it is a "toxic chemical" and have called for further investigations into its side effects. They argue it is a Class A amphetamine which can cause hallucinations, mood swings, severe aggression or even attempted suicide.
Ritalin - or methylphenidate - works on the nervous system to improve concentration, an effect which has earned it its "chemical cosh" nickname.
Janice Hill, of the Overload Network, a support group for parents with hyperactive children, claimed only selective information about Ritalin was given to parents and to health professionals.
She said: "Most of the parents do not know that Ritalin is an amphetamine and has the same pharmacology as cocaine."
The QIS report said greater clinical recognition of ADHD may have contributed to the rise in prescription rates. But it was "unclear" if the increase was below or above the expected level, as an appropriate rate of prescribing methylphenidate has not yet been established.
The Scottish Intercollegiate Guidelines Network (SIGN), which represents several medical groups, says the treatment of ADHD should involve a range of social, pharmacological, psychological, educational and behavioural interventions.
Lord Naren Patel, the QIS chairman, said ADHD had implications for young people’s physical and mental health and their social behaviour.
He said: "It’s important to [ensure] that children who have this condition are diagnosed early on and treated properly. The variation in the treatment throws up the question, ‘Is there a problem here?’ Therefore, we will conduct an audit."
Scotland’s rate of Ritalin prescribing remains below that of Switzerland, Netherlands and Iceland, and is about a third of that in Canada and the United States.
The Royal College of Paediatrics and Child Health backed the Scottish review of regional variations but insisted Ritalin was one of the safest and best researched medicines available for children. It said the drug was an effective way of managing ADHD as part of a wider treatment programme.
Shona Robison, the SNP’s health spokeswoman, said an inquiry into Ritalin prescription rates was "long overdue".
She said: "I raised these concerns almost a year ago when it became apparent that some health authorities were spending huge amounts on Ritalin and prescribing far more of it than others. That says to me that some GPs and doctors are more prone to prescribing it than others, and that some doctors are looking at alternative treatments other than drugs."
A spokeswoman for the Scottish Executive also welcomed the QIS audit.
