ADHD drugs review call in Wales from psychologists

Ritalin drug There was a steep rise in drugs prescribed for ADHD in Wales

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The way drugs to treat a common childhood disorder affecting behaviour are prescribed in Wales should be reviewed, said psychologists.

There was a 57% rise in prescriptions for the most common drug to treat attention deficit hyperactivity disorder (ADHD) between 2007 and 2013.

Experts say the long-term effects of methylphenidate are unknown.

The Welsh government said drug treatment should only be by professionals with ADHD expertise.

Concerns about how ADHD is diagnosed have also been raised by the Association of Education Psychologists.

It is estimated that ADHD affects between 2 to 5% of children and young people.

What is Ritalin

  • Brand name for methylphenidate
  • A stimulant that affects certain chemicals in the brain which may help to reduce some of the symptoms of attention-deficit hyperactivity disorder
  • First used to treat ADHD in 1960s
  • Possible side effects include loss of appetite, nausea, headaches, blurred vision

Source: BBC/NHS

Common symptoms of the disorder, which is normally diagnosed between the ages of three and seven, include inattentiveness, hyperactivity and impulsiveness.

It can be treated with therapy or medication and the most common prescribed drug is methylphenidate, also known as Ritalin.

Figures seen by BBC Wales show there are big variations in the number of prescriptions being given out across Wales.

In the Abertawe Bro Morgannwg University Health Board area - which covers Swansea, Neath Port Talbot and Bridgend - there was an 88% rise to 12,446 from 2007 to 2013.

CASE STUDY: DYLAN PIPER

Zoe Piper and family

Zoe Piper from Bridgend, has a 10-year-old son, Dylan, who was diagnosed at the age of six.

Before he was diagnosed he was expelled from one school after three weeks.

"He was going under the tables, apparently hitting children, he was wetting himself - he actually painted himself green one day," said his mother.

"That was five years ago and everybody still knows him as the naughty child.

"It was a really hard decision for us to put Dylan on medication but weighing it up, it was a case of we had to try the medication or he couldn't continue in the school.

"Once we put him on medication we thought it would completely change him.

"But it didn't change him, the only thing it did was dampen down the extremes of the excitability.

"He still had his little wicked sense of humour, he still had all that going for him.

"The problem was that he was getting used to a dosage so we were going up and up but obviously the higher you go, the more weight you could lose.

"Dylan did get to the point where it was quite dangerous - he lost half a stone - he's under four stone now.

"I made the decision to take him off the methylphenidate and now I've put him onto another drug."

Betsi Cadwaladr Health Board, covering north Wales, produced the most prescriptions - 21,111 in 2013 - with the number rising by 78% since 2007.

Over the last seven years, the Welsh NHS spent over £13m on prescriptions.

Kate Fallon, general secretary of the Association of Education Psychologists, said: "We don't actually have enough research to know what are the long-term effects, particularly of the long-term usage of the drugs, and what effect that might have on these very vulnerable brains of these children if they are being given the drugs at such a young age."

Data on exactly who the prescriptions are going to and how long they have been prescribed the drug are not available.

Ms Fallon added: "You've got some very bald figures here and without knowing the ages of the children or the length of time that the children are on them, then you can't really get a proper picture to say if we tried to implement some of the sorts of programmes might we be able to bring down the use of these drugs.

"I'd be very keen to talk to the Welsh government about suggesting to them that they do look at those figures, and the Welsh government could lead the field in this, in tackling this whole issue of the diagnosis of ADHD and the prescription of drugs and perhaps show to England how it might be done."

A Welsh government spokesperson said: "Drug treatment should only be initiated by an appropriately-qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis.

"Child and adolescent mental health services in Wales have strong working relationships with schools and others agencies to enable any problems to be highlighted and addressed at an early stage."

Health Board 2007 2008 2009 2010 2011 2012 2013

Figures from NHS Wales Shared Services Partnership

Abertawe Bro Morgannwg

6660

7456

8200

9201

10890

11941

12446

Aneurin Bevan

3869

4193

4422

4545

4952

5282

5157

Betsi Cadwaladr

11854

13357

14814

16162

18245

19662

21111

Cardiff and Vale

4106

3606

3947

4053

4121

4868

5673

Cwm Taf

5786

6978

7337

7773

7972

7604

7543

Hywel Dda

4701

5341

5796

6362

6402

6693

6821

Powys

1679

1670

1850

2006

2026

2077

1928

TOTAL

38655

42601

46366

50002

54608

58127

60679

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