More UK children with ADHD should be given Ritalin, say researchers
A major study has endorsed the use of methylphenidate to treat Attention Deficit Hyperactivity Disorder in children and underlines diagnosis shortfall
Use of the drug Ritalin to treat UK children with Attention Deficit Hyperactivity Disorder (ADHD) should be stepped up rather than reduced, a new study suggests.
Evidence shows 5% of children suffer from the behavioural disorder, but only one in 10 are receiving medical treatment.
Experts who took part in the biggest study yet comparing medical treatments for ADHD agreed that many British children with the condition were falling below the diagnostic radar and not getting the help they need.
They were also keen to dispel the myth that ADHD drugs such as methylphenidate, or Ritalin, were a form of “chemical cosh” and children would be better off with less treatment.
I think we have quite strong evidence to suggest that - in the UK and many countries outside the US - ADHD is under recognised and under diagnosed Professor David Coghill, Royal Children's Hospital, Melbourne, Australia
David Coghill, Professor of Child and Adolescent Psychiatry at the Royal Children’s Hospital in Melbourne, Australia, said: “I think we have quite strong evidence to suggest that – in the UK and many countries outside the US – ADHD is under recognised and under diagnosed, and if you don’t recognise and diagnose someone you don’t have the option of what treatment they receive.”
ADHD is a brain disorder characterised by hyperactivity, impulsivity, and an inability to maintain attention. It affects both children and an estimated 2.5% of adults worldwide and can seriously impair quality of life.
Contrary to popular belief, the cause of the condition is under-activity rather than excess activity of certain parts of the brain. All drugs prescribed for ADHD, which include amphetamines, are stimulants, not sedatives.
The new study conducted by a large team of international experts reviewed a wealth of data from 133 trials around the world looking at the effectiveness and tolerability of ADHD drugs.
Around 24,000 patients took part in the trials, including 14,000 children.
After sifting through data, including unpublished results that took four years to collect, the authors concluded Ritalin remained the best medical option for children with ADHD.
In the case of adults, amphetamines turned out to be the most effective treatment that was acceptable to patients.
Ritalin is already recommended as a first line treatment for children with ADHD by the National Institute for Health and Care Excellence (Nice), which vets the cost effectiveness of treatments in England and Wales.
The findings are published in the journal The Lancet Psychiatry.
Speaking at a new briefing in London, members of the research team said it was important to realise that children with ADHD were not simply displaying bad behaviour.
Prof Coghill said: “We now have very clear evidence that the brains of children with ADHD both structurally and functionally are very different.
“That results in a wide range of cognitive difficulties, of difficulties of impulse control, keeping attention.
“The medication treatments are very effective at improving those functional deficits as well as reducing the core symptoms.”
He also stressed the consequences of having ADHD were “far from benign”.
Children with the disorder were far more likely than average to suffer accidents, and adults were at greater risk from traffic accidents either as pedestrians or motorists.
Crime rates were also unusually high among ADHD sufferers.
Co-author Professor Emily Sminoff, from King’s College London, said: “Clinicians are very cautious about using medication in this country.
“The problem in the UK is predominantly about under-recognition and diagnosis across a range of conditions.
“As a result there are a number of children suffering with a range of mental health disorders who could benefit from treatment.”