ADHD: Prescription of Ritalin is restricted

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Joint Federal Committee wants to restrict the prescription of ADHD drugs such as Ritalin.

(09/20/2010) Restless and fidgety children are all too often perceived as a disruptive factor in school operations - the diagnosis that is quickly made is usually ADD or ADHD. Then the affected children are usually treated with medicines that contain "methylphenidate". However, the Federal Joint Committee now wants to prevent this approach, since the side effects of the medicines are too serious and the prescription has been handled too lightly in the past.

The Federal Joint Committee (G-BA) is the highest decision-making body for the joint self-administration of doctors, dentists, psychotherapists, hospitals and health insurers. Here, the service catalog of statutory health insurances (GKV) is defined on the basis of guidelines. H. determines the medical services for which reimbursement is provided by the SHI. In addition, the G-BA is responsible for quality assurance measures in outpatient and inpatient healthcare.

There are several good reasons why the G-BA now wants to reduce the supply of psychoanaleptics containing methylphenidate to children and adolescents because of possible risks. On the one hand, the side effects of the preparations are considerable, so that the usual long-term medication appears more than negligent in the eyes of the committee. On the other hand, more and more such medicines have been prescribed in recent years, with the G-BA believing that the administration of Ritalin and Co. was relatively often based on a misdiagnosis. According to the G-BA, general practitioners without additional training are unable to make a sensible decision about prescribing medicinal products containing methylphenidate. According to estimates by experts, around 407,000 patients in Germany received medicinal products with the active ingredient methylphenidate in 2007; in 2008 the figure was a good 5 percent more. Every year the number of ADS and ADHD patients treated with such preparations increases, with over 50 percent of the medicinal products containing methylphenidate being prescribed by pediatricians.

To counteract the worrying development, in the future only specialists for behavioral disorders in children and adolescents (child and adolescent psychiatrists with social psychiatry agreement) will be able to prescribe the controversial active ingredient. A clear diagnosis must be available and those affected should be informed about psychological, educational and curative education options as alternatives to the use of methylphenidate. In the G-BA's view, it must also be clear to every ADD or ADHD patient that preparations such as Ritalin, Concerta, Medikinet or Equasym only limit the symptoms of the “fidgety syndrome” but do not combat the causes of the disease. In no case should permanent medication be carried out without interruptions. Rather, the administration of the medicinal products should be suspended on a regular basis in order to check the effects on the children's health, stressed the impartial chairman of the G-BA, Rainer Hess. In order to be valid, the new drug guidelines still have to be confirmed by the Federal Ministry of Health and published in the Federal Gazette.

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) have been known in medicine for over 100 years. However, the number of diagnoses has only increased massively in recent decades, so that the disease is sometimes considered a phenomenon of modern industrial society. It can affect not only children and adolescents but also adults. ADS or ADHD patients are severely impaired in their ability to concentrate and have difficulty controlling their impulses. Many of the approximately 500,000 children affected in Germany are also hyperactive, with boys suffering from ADS / ADHD on average about three times as often as girls.

Since the organism is particularly sensitive to the administration of psychoanaleptics in adolescents, continuous treatment with medicinal products containing methylphenidate is particularly critical for them. In addition, several studies have been carried out in the USA, which suggest that around one million children with an incorrect diagnosis of ADHD live there. According to the experts, the number of incorrectly made ADHD diagnoses in Germany should be similar, although just looking at the most common criteria for determining an ADHD disease shows how many false diagnoses can be made. This is because statements such as "often ignore details or make careless mistakes when doing school work, at work or in other activities" or "have difficulty keeping attention on tasks for a long time" or "can often be easily distracted by external stimuli" towards a relatively large number of children. If you do not want to expose your child to permanent medication after a corresponding diagnosis, from a naturopathic point of view there are various variants of psychotherapy and, alternatively, neurofeedback as a special form of biofeedback training. (fp)

Read about ADHD:
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Attention Deficit Disorder ADHD
Cannabis effective for ADHD?
Often wrong ADHD diagnosis in children
Environmental factors in ADHD hardly examined

Image: Dieter Schütz /

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