http://news.scotsman.com/health.cfm?id=62992004
Medical opinion divided over rise in Ritalin use
TOM CURTIS
ATTENTION Deficit Hyperactivity Disorder (ADHD) is a specific medical condition
not to be confused with normal boisterous behaviour.
All children have occasional periods of heightened activity occasionally, but
those with ADHD are clearly more excitable, active and distracted than other
youngsters.
They tend to be boys and often do not recognise social boundaries of behaviour.
They may be verbally abusive and sometimes violent. ADHD is a factor in a
significant amount of juvenile crime, although by no means all sufferers are
offenders.
The condition seems to run in families and may be caused by an imbalance of
chemicals in the brain known as neurotransmitters. It is usually diagnosed
after a child starts nursery or school.
Many experts argue medication should only be used with a programme of
behavioural management. Others believe ADHD is being diagnosed in children who
are not ill, which could account for a massive rise in cases in the UK.
However, some studies have suggested that the greatest response among sufferers
is to medication, and many practitioners support its use as the main line of
treatment.
Ritalin, the most commonly used drug, stimulates the brain and has effects
similar to, but more potent than, caffeine but less powerful than amphetamines.
It is thought to work by increasing levels of dopamine, which helps with
electrical signalling in the brain, improving concentration in individuals who
have dopamine signals that are weak. Risperidone works in a similar way.
Patrick Cosgrove, who faces a GMC hearing tomorrow over his treatment of
children with ADHD, has said a survey of parents of 326 children with severe
and complex ADHD had shown good results from "Risperidone augmentation
therapy".
However, opponents claim children have become depressed taking such drugs.
There are also concerns about "off-label" prescribing to children drugs
designed for use in adults.
Despite this, Scottish Executive figures suggest there are 30,000 annual
prescriptions of Ritalin-type drugs annually, up 68% on 1999.