A study has cast doubt over the use of Ritalin for treating attention deficit hyperactivity disorder after reviewing all available evidence. Another study shows how badly it “may cause poor sleep” (CBS’ words exactly)
The paper’s authors said that the effect of the widely used drug on ADHD symptoms remained uncertain.
There were nearly a million prescriptions for Ritalin, the best known brand name of the drug methylphenidate, and related drugs dispensed last year. ADHD affects an estimated 5 per cent of children. Sufferers may have difficulty focusing attention and remaining “on task” and show excessively impulsive behaviour and hyperactivity.
The review, published in the Cochrane Library, found that Ritalin appeared to produce modest improvements in symptoms, general behaviour and quality of life, the researchers said that the quality of evidence was poor. There were also signs that children on the drug were more likely to experience sleep problems and loss of appetite, leading the researchers to urge more caution in its use.
The researchers looked at data from 185 randomized controlled trials involving more than 12,000 children and adolescents aged 3 to 18. They said that their confidence in all results was very low, with incomplete results reported for many trials, and the methods used meant that people involved would have known which children were on Ritalin and which were on a placebo.
Camilla Groth, a co-author, said: “This review shows very limited quality evidence for the effects of methylphenidate on children and adolescents with ADHD. Some might benefit, but we still don’t know which patients will do so. Clinicians prescribing methylphenidate must take account of the poor quality of the evidence, monitor treatment carefully, and weigh up the benefits and adverse effects.”
Another co-author of the report, Dr Morris Zwi, said that doctors and families should not rush to stop using Ritalin. He said: “If a child or young person has experienced benefits without adverse effects, there may be good clinical grounds to continue using it. Patients and their parents should discuss any decision to stop treatment with their health professional before doing so.”
Professor Guy Goodwin, president of the European College of Neuropsychopharmacology, said: “This review presents no new data and provides no reason to doubt that medication makes a major difference to the health of many young people with severe ADHD.” But then he would, wouldn’t he.