Ritalin
calms hyperactive children and prescriptions are soaring - but experts warn of
serious side-effects and it's even being linked to suicide.
http://www.dailymail.co.uk/health/article-2141044/ADHD-Ritalin-prescriptions-soaring-experts-warn-effects.html
http://www.dailymail.co.uk/health/article-2141044/ADHD-Ritalin-prescriptions-soaring-experts-warn-effects.html
By John Naish
PUBLISHED:
00:29, 8 May 2012 | UPDATED: 09:09, 9 May 2012
When the school holidays arrive, Andrea Antunes makes sure her son
Ruben, ten, has a break — not just from classwork, but from the Ritalin pills
he takes each day.
Four years ago, Ruben was diagnosed with Attention Deficit Hyperactivity
Disorder (ADHD), a syndrome which causes hyperactivity, restlessness and
inattention. His school told Andrea Ruben faced exclusion unless he took drugs
to control his behaviour.
The drugs dull his hyperactive tendencies, but Andrea, 37, a mother of
two from Norwich, dislikes them — in fact, she avoids them whenever possible.
Concern:
Andrea Antunes and her son, Ruben
‘When he is off Ritalin, he will run around, ride his bike, not sit
still,’ she says. ‘But he sleeps and eats better. The drugs keep him wakeful
and reduce his appetite.’
Andrea’s reluctance to medicate her son’s behaviour unnecessarily seems
very wise.
Figures released last week showed prescriptions of Ritalin have
quadrupled in the last decade — from 158,000 in 1999 to 661,463 in 2010 — with
children as young as three taking the powerful medication.
This massive growth comes despite warnings from experts that the more
children take ADHD drugs, the more ‘rare’ but lethal side-effects, such as
suicidal thoughts and psychosis, become common.
This human toll was starkly revealed at the inquest last year of
ten-year-old Harry Hucknall, who killed himself while on a high dose of
Ritalin.
The youngster, a cousin twice-removed of the singer Mick Hucknall, had
ADHD. The level of Ritalin found in his system was above the normal therapeutic
level and he was also on drugs for depression when he was found at his home in
Dalton-in-Furness, Cumbria, in September 2010.
The West Cumbria coroner, Ian Smith, said doctors must be ‘extremely
careful’ in prescribing drugs to ten-year-olds.
‘We as a society try to stop children dabbling in street drugs and yet a
child with this label of ADHD is prescribed mind-altering drugs of a very
powerful nature — the full consequences of which I do not believe are fully
understood,’ he said.
The case echoes an earlier tragedy, in 2008, when 15-year-old Anthony
Cole hanged himself in his bedroom after his Ritalin prescription was increased.
The Milton Keynes schoolboy had been on the drug for six years, having been
diagnosed with ADHD at the age of nine.
This week, the Association of Educational Psychologists (AEP) said that
in a worrying new trend its members are seeing Ritalin dosages being increased
over time.
Ritalin
- also known as methylphenidate - is being increasingly prescribed to young
children to tackle hyperactivity
‘The benefits of psychostimulant medication are not sustainable over the
long term, necessitating stronger and stronger dosages,’ it said, adding that
it was becoming, ‘common practice for children to be prescribed stronger
dosages than recommended in the morning as a “kick-start” so medication lasts
the school day’.
The AEP also found a substantial increase in children under six on
Ritalin even though the National Institute for Health and Clinical
Excellence (Nice) watchdog recommends it is not prescribed to pre-school
children.
Children on ADHD medication can be exposed to serious risks. Suicidal
thoughts are among a battery of known side-effects of Ritalin-type drugs.
Others include stress and anxiety, cardiovascular complaints, decreased
appetite, stomach problems, dizziness, tics, skin problems and bruising. In
2009, the EU regulator, the European Medicines Agency, said all patients should
be monitored for psychiatric symptoms during treatment. The agency added that,
given the lack of information on the long-term effects of Ritalin, children
should have treatment stopped once yearly to see if it is still needed.
'Children who are anxious may misbehave and be fidgety, but those
symptoms must not be mistaken for ADHD'
But experts say the rules are being widely ignored, often because
healthcare professionals’ workloads are already too heavy to take on the job of
monitoring children regularly.
Dave Traxson, an educational psychologist who works across schools in
the West Midlands, adds that psychiatrists are also flouting NICE guidelines,
which stress that children who show evidence of anxiety should not be put on
Ritalin-type stimulant drugs.
‘Children who are anxious may misbehave and be fidgety, but those
symptoms must not be mistaken for ADHD,’ he says. ‘The last thing you want if
you are feeling anxious is to take a stimulant drug.’
The guidelines also advise that children on these drugs be weighed every
six months, as the medication can severely shrink their appetites.
But, says Traxson: ‘This rule is being breached all over the country.
One group of psychiatrists told me point-blank that they do not have the staff
to do this. If they haven’t the resources to do the thing safely, should they
be doing it at all?’
These are not the words of a lone maverick. Traxson has won the backing
of the British Psychological Society (BPS) and the AEP. The AEP is now drafting
a call for a nationwide government review on the issue before still more
children are put on the drugs.
Peter Kinderman, a chair of the BPS, says: ‘Children are being
prescribed medication as a quick-fix rather than being given full assessments
and psychological therapies, which may take longer and cost more but ultimately
are better in the long run.’
Indeed, recent research proves that drug-free approaches can dispel the
symptoms of ADHD.
A Colorado University study in 2010 showed that when 150 adolescents
diagnosed with the disorder were given sessions of cognitive-behavioural
therapy plus an inactive sugar pill (which they were told was a
Ritalin-type drug), their symptoms disappeared just as effectively as in 150
adolescents who were given both the therapy and a chemically active
Ritalin-type drug.
A similar placebo effect was seen in a study of children whose parents
and teachers were told they had been put on another kind of ADHD drug, called
Adderall, which in fact was a placebo pill.
So what had happened? Dr Daniel Waschbusch of Florida International
University, who led the research, says: ‘Thinking a child has received
medication may induce positive expectations in parents and teachers.
‘In turn, this may influence how parents and teachers evaluate and
behave towards the children.’
Such research indicates that a significant number of ADHD cases may be
in the mind — both of young people and of their parents and teachers. The more
we believe in ADHD, the more we see of it, and the more we dose children with
potentially dangerous drugs without monitoring them for dangerous responses.
This latter concern is shared by Professor Peter Helms, a professor of
child health at Aberdeen University, who recently published a study in the
journal Drug Safety on ADHD drugs. ‘The effects on people who have been on the
drugs for years is a potential problem.
‘Clinical trials give us only short-term answers, as the trials last a
year at the most. We should introduce monitoring systems to check what is
happening with patients.’
Indeed, one important study in 2007 found there are no benefits to
giving children medication after they have been taking the drug for three
years.
British GPs agree that many are left on Ritalin for more than three
years, and often as many as six.
Furthermore, there is also disturbing evidence from studies on
laboratory rats that giving Ritalin-type drugs to adolescents may cause them
mental problems when they are adults. These may include memory damage and
depression. In humans, there have been no studies to explore this, because it
is illegal to test drugs on children.
Instead, something else is happening: we are effectively witnessing an
uncontrolled chemical trial that involves the mass-medication of thousands of
youngsters across Britain. What is even more tragic is that we are not even
trying to monitor these children for early evidence of the serious problems this
may cause.
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