Ritalin 'should be avoided'

12 April 2012

Ritalin, the controversial drug used to calm down hyperactive children, should be avoided wherever possible and not given at all to the under-fives, according to new health guidelines.

Instead, parents should be taught psychological techniques for changing the behaviour of unruly children diagnosed with attention deficit hyperactivity disorder (ADHD), said experts.

Teachers trained in ADHD management were also urged to put their skills into practice in the classroom.

Methylphenidate, better known as the stimulant Ritalin, and other drugs should be reserved for severe cases only after other options have failed, health professionals were told.

The guidelines were issued by the National Institute for health and Clinical Excellence (Nice) and the National Collaborating Centre for Mental Health.

They aim to provide a blueprint of best practice for identifying and treating children with ADHD in England and Wales and combat excess use of drugs.

Up to 3% of school-age children and young people are affected by the disorder in the UK. It has recently been recognised that around 2% of adults also suffer from the problem. Previously they were often wrongly labelled as having a personality disorder or a psychological condition.

The causes of ADHD are unclear but thought to include both genetic and environmental influences. Diet may be involved and a link with fizzy drinks has been suggested. Problems in the womb or birth trauma could also cause damage in the brain leading to ADHD.

Dr Tim Kendall, a consultant psychiatrist from Sheffield who is joint director of the National Collaborating Centre for Mental Health and helped draw up the guidelines, said: "Its easier to prescribe a drug when other options like parent training programmes are not available."

The guidelines say parent training and education programmes should be offered as a first-line treatment for ADHD, both for pre-school and school age children.

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