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Volume 410: debated on Friday 19 September 2003

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To ask the Secretary of State for Health if he plans to investigate the extent of Methylphenidate prescribing in the UK. [130259]

Information is collected on the number of prescription items of all Methylphenidate drugs dispensed in the community. The data include prescriptions prescribed in general practitioner practices, and prescriptions prescribed in hospitals that have been dispensed in the community. Private prescriptions, and prescriptions dispensed in hospitals are not included. Numbers of prescriptions in England for the years 1997 to 2002 are set out in the table.

Items (Thousand)
In 2000, the National Institute for Clinical Excellence (NICE) made an appraisal of the use of Methylphenidate in the treatment of attention deficit hyperactivity disorder (ADHD). NICE estimated that approximately 1 per cent. of all school-aged children—about 69,000 of 6 to 16-year-olds in England met the diagnostic criteria for Hyperkinetic Disorder, the more severe type ADHD, of whom some 45,000 might benefit from Methylphenidate were not receiving this treatment. A review of the appraisal is planned for this year.

To ask the Secretary of State for Health what the (a) short and (b) long-term adverse effects are described with Methylphenidate. [130260]

Methylphenidate (sold in the UK as Ritalin, Equasym and Concerta XL) is licensed for use in children over six years of age as part of a comprehensive treatment programme for attention deficit hyperactivity disorder, where remedial measures alone prove insufficient.

The most common short-term adverse effects generally occur at the beginning of treatment, and include central nervous system effects, such as nervousness and insomnia, and gastro-intestinal effects, such as abdominal pain, nausea and vomiting.

The long-term safety and efficacy profiles of methylphenidate are not fully known. This is reflected in the product information of Ritalin provided to prescribers which advises that patients requiring long-term therapy should be carefully monitored. It warns of the risk of moderately reduced weight gain and slight growth retardation with the long-term use of stimulants in children and that careful monitoring of growth is recommended. It also recommends that blood tests should be performed periodically during long-term use.