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Health: Ritalin

Volume 696: debated on Wednesday 14 November 2007

asked Her Majesty’s Government:

What action they will take in the light of the report of the University at Buffalo on the long-term inefficacy of Ritalin.

My Lords, a Europe-wide review of the efficacy and safety of methylphenidate began in June and it will consider the findings of the University at Buffalo’s report. Following the review, any necessary updates will be made to guidance for prescribers and the information provided for patients. The review will also inform the NICE guidance on the pharmacological and psychological interventions to treat attention deficit hyperactivity disorder—ADHD—which should be published in July 2008.

My Lords, I thank the Minister for her reply. However, does she think that the time might now be right for the Government to commission an inquiry into the causes of ADHD, beyond merely evaluating the current medication? Given the more than threefold increase in prescriptions over the past 10 years, might it not be valuable to explore the concomitant possible changes over that period in environmental, dietary and social factors?

My Lords, I well understand the noble Baroness’s concern about the apparent increase in ADHD. It is not clear whether the percentage of children with ADHD has increased in recent years or whether this reflects greater awareness of the condition. But the suggestion that there should be a wide-ranging review is certainly interesting, although it would of course go far wider than the Department of Health—it would have to be a cross-Government initiative. I will therefore take it back to my colleagues, who will discuss the suggestion with the noble Baroness. I assure her that we will pursue it.

My Lords, is the Minister aware of research linking ADHD with post-natal depression? Many parents do not realise that they are suffering from post-natal depression, making the role of health visitors essential in addressing it early. Can the Minister tell me or write to me about what she is doing to recruit young men and women into the health visiting profession to tackle this problem? I understand that it is an ageing professional group.

My Lords, I was unaware of the relationship between post-natal depression and ADHD, and will therefore write to the noble Earl. He makes a valid point about the importance of health visitors and the need for more. The Government are acutely aware of this, and I will get back to him with further details.

My Lords, ADHD was first described in 1902, but there is as yet no diagnostic test for it. Can the Minister say whether the Department of Health and the Department for Children, Families and Schools would fund research into a better diagnostic test for general practitioners?

My Lords, funding is always a difficult issue. However, I well understand the need for a diagnostic test, so I will also have to come back to this in writing. There is a range of options for dealing with ADHD, such as psychotherapies, drugs and all sorts of things. Clearly, the most important thing is to have a diagnosis so that we get the treatment right.

My Lords, does the Minister recognise that it is difficult to assess the effect of drugs on behaviour, whereas it is much easier to assess the effect of a drug on, say, an infection? I am therefore sure that the Minister is right in not being too quick to draw conclusions from one bit of research in Buffalo.

My Lords, the noble Lord is absolutely right; that is one of the problems thus far. There is a lack of data on the impact that treatment has had on ADHD. It is perhaps not a recent phenomenon, but Ritalin, for example, has only been prescribed since 1988. Sadly, the long-term data are currently lacking.

My Lords, do the Government have any data on the extent of abuse of methylphenidate, given press reports that students are using it to improve their concentration when coming up to exams and because its effects on the body are similar to that of cocaine and other amphetamines?

My Lords, I, too, have read the deeply disturbing press articles. We have no evidence that it is being prescribed wrongly in a great number of cases. It is clearly being prescribed wrongly in a certain number of cases, or the incidents would not happen, but the Government are aware of this and, I am sure, are taking appropriate action.

My Lords, I declare an interest as the chair of the review of autism in Northern Ireland. Will the Minister extend her thinking beyond merely ADHD? Will she look at ASD where one finds that there is an abuse of Ritalin? One sometimes thinks it is an abuse through ignorance on the part of GPs who, since the Government have not produced a coherent and co-ordinated policy on autism, do not understand, so only behavioural problems are being tackled. There are also communication and sensory problems, and the objective must be to create transferable skills in autistic children.

My Lords, I pay tribute to the noble Lord for his work in the field of autism. I declare an interest as I am a past president of Autism Cymru, another excellent organisation. ASD is extremely important. I undertook to suggest to the department that the suggestion of the noble Baroness, Lady Greenfield, should be looked at further. I will also pass on the comments made by the noble Lord, but, in doing so, I give absolutely no undertakings on behalf of the Government.