ADHD prescription of Ritalin is restricted

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

(20.09.2010) Restless and fidgety children are all too often perceived as a disruptive factor in school operations - the diagnosis made quickly is then mostly ADD or ADHD. Subsequently, the affected children are usually treated with medicines that „methylphenidate“ contain. However, the Federal Joint Committee now wants to prevent this procedure because the side effects of the drugs are too serious and the prescription has been treated too lightly in the past.

The Federal Joint Committee (G-BA) is the highest decision-making body of the joint self-administration of physicians, dentists, psychotherapists, hospitals and health insurances. Here, the service catalog of the statutory health insurance (SHI) is determined by means of guidelines, ie. H. determines for which medical services a reimbursement by the GKV takes place. In addition, the G-BA is responsible for quality assurance measures in the outpatient and inpatient areas of the health care system.

The fact that the G-BA now wants to reduce the supply of methylphenidate-containing psychoanaleptics for children and adolescents because of possible risks, has several good reasons. On the one hand, the side effects of the preparations are considerable, so that the usual long-term medication in the eyes of the committee seems more than negligent. On the other hand, in recent years, more and more of these drugs were prescribed, with the administration of Ritalin and Co., according to the G-BA relatively often based on a misdiagnosis. According to the G-BA, general practitioners without additional training are not in a position to make a meaningful decision on the prescription of methylphenidate-containing medicines. In 2007, according to experts' estimates, around 407,000 patients in Germany received drugs with the active ingredient methylphenidate, in 2008 it was just over 5 percent more. Year after year, the number of ADHD and ADHD patients treated with these products is increasing, with more than 50 percent of methylphenidate-containing medicines prescribed by paediatricians.

In order 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) should be able to prescribe the controversial drug. There must be a clear diagnosis and those affected should be educated about psychological, educational and curative education as alternatives to Methylphenidat use. Also, in the view of the G-BA every ADD or ADHD patient must be aware that preparations such as Ritalin, Concerta, Medikinet or Equasym merely the symptoms of the „Zappelphilippsyndroms“ restrict, but not fight the causes of the disease. In no case should a permanent medication be given without interruptions. On the contrary, the administration of the medicinal products should be regularly suspended in order to check the effects on the health status of the children, the impartial chairman of the G-BA emphasized. Rainer Hess. In order to be valid, the new drug guidelines must still be confirmed by the Federal Ministry of Health and published in the Federal Gazette.

Attention Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD) have been known in medicine for over 100 years. However, the number of diagnoses has increased massively only in recent decades, so that the disease is sometimes regarded as a phenomenon of modern industrial society. It can affect not only children and teenagers but also adults. ADHD and 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 on average about three times as often ADHD / ADHD as girls.

Since the organism in adolescents is still particularly sensitive to the administration of psychoanaleptics, the continuous treatment with methylphenidate-containing medicines is particularly critical for them. In addition, several studies have been conducted in the US suggesting that around one million children are diagnosed with ADHD. In the opinion of the experts, the number of incorrectly prepared ADHD diagnoses in Germany may look similar, but the consideration of the most common criteria for the detection of ADHD alone makes it clear how many false diagnoses can be made. Because statements like „Often ignores details or makes careless mistakes during schoolwork, at work or during other activities“ or. „has difficulty maintaining attention for tasks for a long time“ or „is often easily distracted by external stimuli“, meet a relatively large number of children. Anyone who does not want to expose their child to long-term use of medication after having been diagnosed can choose from a variety of psychotherapy options, as well as neurofeedback as a special form of biofeedback training, from a naturopathic point of view. (Fp)

Read about ADHD:
ADHD: Ritalin only in exceptional cases
Attention Deficit Disorder ADHD
Cannabis effective in ADHD?
Often wrong ADHD diagnosis in children
Environmental factors hardly investigated in ADHD

Image: Dieter Schütz