- The National Institute for Clinical Excellence (NICE),
an independent watchdog that rules on the appropriate use of drugs, is
to recommend that Ritalin should not be given to children under five years
of age. Whilst it may still be prescribed for older children, there will
be clearer definitions of the conditions for its use.
- Ritalin (methylphenidate), an amphetamine-like stimulant,
was referred to NICE by Health Secretary Alan Milburn. It is prescribed
for children who are diagnosed as having Attention Deficit Hyperactivity
- ADHD is defined as "developmentally inappropriate
inattention and impassivity, with or without hyperactivity. Symptoms attributed
to the condition include distraction, impatience and difficulty concentrating.
It occurs in children of both sexes, but is diagnosed four times more frequently
in boys. However, it is a condition whose clinical recognition is disputed
by some in the medical profession.
- In the last decade prescriptions for Ritalin virtually
doubled every year. However, last year only 157,900 prescriptions were
issued compared to 126,500 the year before following growing fears over
the increasing use of drugs to treat hyperactivity among children, some
as young as two. Steve Baldwin, professor of clinical psychology at Teeside
University, has consistently opposed the prescription of Ritalin. He said,
"There's definitely the start of a levelling off. Doctors are getting
very worried about prescribing it.
- In the BBC documentary entitled Kids On Pills, screened
earlier this year, Baldwin described the effect of Ritalin on children:
"Apparently the child is improving but what's really happening is
there is less behaviour and the emotion is cut off and the feeling is cut
off, and what we're left with is children that behave like robots and zombies.
- Parents concerned about the side effects the drug is
having on their children have taken out court proceedings against doctors
and drug companies. In the North-West, a group of parents are trying to
bring to account doctors they claim have ignored the manufacturer's recommendations
that Ritalin only be prescribed for children over five, and then only for
a month at a time. In Texas, parents are taking action against Norvatis
Pharmaceuticals, the manufacturer of Ritalin, for an alleged failure to
warn of its impact on children's cardiovascular and nervous systems. Overload,
a charity based in Scotland, is pursuing action against various National
Health Service Trusts in connection with the side effects suffered by children
while on psychotropic drugs.
- A new lobby group, Stimulants Are Not The Answer (Santa),
has also been set up to press for legislative changes that will tighten
up the availability of Ritalin. Their website (www.santa.inuk.com) opposes
the notion that ADHD is caused by a brain disorder for which stimulant
medication is the only effective answer. They stress that to find the right
treatment; ADHD should not be regarded as a single specific disorder but
an umbrella term for all kinds of possible problems that can lead to uncontrollable
behaviour. The problem must generally be viewed as a social/psychological
issue, rather than a biological one, they insist.
- Santa's coordinator Eileen Tracy recently told the Independent
newspaper; "In France they have hardly any incidence of ADHD. If you
want to put a child on a stimulant, you have to go to a hospital, you can't
just go to a GP [General Practitioner].
- Richard DeGrandpre, an American pharmo-psychologist,
author of Ritalin Nation, says that ADHD is not a medical condition but
a result of today's rushed society, which causes vulnerable children to
crave stimuli. He says that whilst Ritalin is chemically different to cocaine,
its effects are the same. It works by feeding the craving with a backdrop
of stimulation, but gives the children the opposite of what they need,
which is a calmer, quieter, more engaged routine to wean them away from
their need for continual sensation.
- Recently a study published in the Journal of Sleep Research
cited sleep deprivation among children as another factor that leads a number
of them to be misdiagnosed as either having ADHD or suffering a mental
illness. The study carried out in Holland found that large numbers of children
are either not sleeping long enough, or their sleep is of poor quality.
According to their findings, one in four children aged between nine and
14 years of age do not feel rested at school and 15 percent have sleep
- The main cause cited for this increase in sleep problems
was the turning of bedrooms into entertainment centres with television
and video games, more permissiveness about bedtimes and working parents
returning home late and keeping children awake longer in order to enjoy
time with them. The report concluded: "Children who feel better rested
display a more positive self-image, more achievement motivation, have more
control over their aggressive behaviour, are less bored and are more receptive
to their teacher.
- Professor Gregory Stores, head of research into child
sleep disorders at Oxford University, said that children's sleep suffers
as a result of them being wound-up before settling. He explained that the
symptoms of many sleepless children were misleading because they are unlike
those of adults. Such pupils deprived of sleep tend to display hyperactivity,
as well as being irritable, depressed, inattentive and disruptive. As a
result they can be wrongly diagnosed as having ADHD and be put on Ritalin,
which only makes the problem worse.
- Extreme neglect due to poverty and instability in the
home is also a common contributory factor to sleeplessness and hunger,
which leads to many of the behaviour patterns described by Stores.
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