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The BBC's Karen Allen
"Todays guidance offers little comfort"
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BBC correspondent Arabella Schnadhorst
"Prescribing ritalin to children rouses strong feelings"
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Andrew Dillon, NICE chief executive
"Parents can be confident that the drug is being used in the right way"
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Tuesday, 31 October, 2000, 12:30 GMT
NHS go-ahead for hyperactivity drug
Ritalin is given to hundreds of thousands of US children
The National Institute for Clinical Excellence (NICE) has decided that a controversial drug should be prescribed on the NHS to children with serious hyperactivity problems.

The ruling could mean thousands more children are prescribed the drug in the UK. It could cost the NHS in England and Wales an extra 7million a year.

Ritalin is designed to treat a condition known as attention deficit hyperactivity disorder (ADHD). NICE has decided that the drug is suitable for children diagnosed with severe ADHD.

It's time British doctors came out and said they have got it wrong - it's sad to see the US so far ahead

Gill Mead, ADHD Family Support Group
The institute estimates that around 48,000 children in England and Wales would benefit from the drug, but are not currently receiving it.

The symptoms of ADHD range from poor concentration and extreme hyperactivity to interrupting and intruding on other people and not being able to wait in queues.

Ritalin is a mild stimulant - an amphetamine - that works on the central nervous system to improve concentration.

The drug is commonly used in the US. Treatment rates for hyperactivity in some American schools are as high as 30% to 40% of a class and children as young as one have been known to have been given the drug.

But in the UK many psychiatrists are reluctant to prescribe these so-called psychoactive drugs for children.

Even so, the number of prescriptions for ritalin in the UK doubled every year until 1999, when they went up to 157,900 from 126,500 in 1998.

Study findings

A study published in the Journal of the American Medical Association last year found drugs such as Ritalin work better at treating attention deficit hyperactivity disorder (ADHD) than behavioural therapy.

nursery school
Opponents say the drug is used to cancel out childhood boisterousness
Opponents of the widespread use of the drug fear it may have unpleasant side-effects, leaving some children robotic, lethargic, depressed, or withdrawn.

They also fear some parents, doctors and teachers are using the drug to cancel out perfectly natural childhood boisterousness and creativity.

Gill Mead, the President of the ADHD Family Support Group, has called for ritalin to be made more widely available in the UK.

She said: "It's time British doctors came out and said they have got it wrong - it's sad to see the US so far ahead."

However, Dr Stephen Baldwin, a child psychiatrist at the University of Teeside, opposes giving ritalin to children.

He said: "There are at least 230 alternative therapies to giving powerful psycho-stimulants to children.

"The axis question in contemporary Britain is whether or not we, as practitioners, clinicians, researchers, parents think that children as young as four, five or six should be given amphetamines, and the answer is no."

Cost of drug

Ritalin costs around 200 a year for a child on an average daily dose of 30mg, but the bill rises to up to 1,000 when assessment and follow-up costs are taken into account.

The drug, made by Novartis Pharmaceuticals, is not licensed for people under six, but doctors have prescribed it to children as young as 15 months.

The Nice guidelines reiterate that its licence is restricted to children over five and calls for "multi-disciplinary assessments" of youngsters before they are prescribed the drug.

It also says Ritalin should only be prescribed in the first place by a child psychiatrist or paediatrician, but GPs should be able to offer repeat prescriptions.

The NICE guidelines are not legally enforceable, but doctors who flout them will have to be prepared to explain their actions to health authorities.

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