Children with attention deficit hyperactivity disorder (ADHD) should be treated with drugs such as Ritalin only in severe cases and never when they are younger than 5, under official health guidelines issued today. Widespread concerns that medication is used too freely to calm hyperactive children have been recognised by two clinical practice watchdogs, which are now advising doctors not to prescribe drugs whenever possible.
Most children with ADHD should instead be offered psychological therapy to improve their behaviour, backed up by training to support their parents and teachers, the National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Mental Health (NCCMH) recommend.Drugs such as Ritalin and Concerta (brand names for methylphenidate) and Strattera (atomoxetine) should be used as frontline treatments only when severe ADHD is diagnosed, or when other options have failed.
While up to 3 per cent of school-age children in Britain are affected by ADHD, only about a third to a quarter of these would qualify as severe cases. In a typical school of 1,400 children, between 30 and 40 would have a diagnosis of ADHD, and about 10 would be classed as severely affected.
The symptoms of ADHD include an inability to concentrate for long periods, hyperactive and restless behaviour, and impulsive actions, such as speaking without thinking of the consequences or failing to wait and take turns. It also affects about 2 per cent of adults.
ADHD support groups welcomed the guidelines, but said that they would have to be backed by increased resources for behavioural therapy if they are to have the desired effect.