Drug for `Difficult' Children Approved ; Medical Experts Are Criticised for Sanctioning the Widespread Use of Controversial Treatment for Thousands of Hyperactive Youngsters

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DOCTORS WERE given the go-ahead yesterday to use the amphetamine derivative Ritalin to treat young people with attention deficit disorder, reopening the controversy over the drugging of children to control difficult behaviour.

Attention deficit/hyperactivity disorder (ADHD), which is estimated to affect 73,000 children in England and Wales, 1 per cent of the school- age population, leaves sufferers unable to concentrate, prone to fidget and act impulsively, causing difficulties at home and school and imposing immense strain on families.

The Government's watchdog on new treatments, the National Institute for Clinical Excellence, said in new guidance that drugs "should be used as part of a comprehensive treatment programme" for severely affected children.

The ruling is likely to lead to thousands more children being prescribed Ritalin, which has suffered from widely variable availability around the country.

The institute said 48,000 of the 73,000 children who might benefit from the drug were not getting it. A year-long course of the drug costs pounds 200 but specialist assessment and follow-up recommended by the institute would increase the cost to pounds 500- pounds 1,000, adding up to pounds 37m a year to the treatment bill nationally.

The drug, whose chemical name is methylphenidate, has been available for 40 years but its use in children has grown sharply in the last decade from 3,500 prescriptions in 1993 to 157,900 in 1998.

The ruling has angered campaigners opposed to drug treatment of children. Jean Robb, educational therapist at the Successful Learning Centre, in West Kirby, Merseyside, an after-school unit for children with problems, and co-author of a book on ADHD, said: "It's ridiculous. What we need to be looking at is why parents have difficulty raising their children in today's society. It is dangerous to tell children they can only be handled through drugs - it gives them the wrong message and their parents too."

Janice Hill from the support group Overload, which campaigns against over-prescription of drugs for children, said: "We are disappointed with these guidelines as they do not address any of the safety concerns about Ritalin.These are things like amphetamines that we are giving our kids."

The evidence that methylphenidate, which is available in Britain under the brand names Ritalin and Equasym, is effective in ADHD is now overwhelming, according to experts. More than a dozen studies have shown that sufferers have a genetic abnormality of the dopamine system in the brain which can be corrected by the drug.

Professor Peter Hill, consultant in child and adolescent psychiatry at Great Ormond Street Hospital for children and an international expert on ADHD, said: "I don't think there is any doubt at all that in medical terms methylphenidate is an effective way of squashing the symptoms. …