July 11 2006
Doctors are likely to be allowed to prescribe Ritalin to preschoolers under new national ADHD guidelines to be drawn up next year, despite federal Government concerns.
Ritalin's manufacturer, Novartis, currently advises against giving the drug to children under six, saying its usefulness and safety are not known.
But preliminary findings from a US health review have given Australian pediatricians confidence they are right to prescribe the stimulant drug to pre-schoolers with attention deficit hyperactivity disorder.
The practice of prescribing Ritalin to preschoolers against drug company advice was revealed in The Weekend Australian.
The Howard Government's Parliamentary Secretary for Health, Christopher Pyne, said he was "very concerned" and yesterday asked the national drug watchdog, the Therapeutic Goods Administration, to advise on any options for reining in inappropriate prescribing.
Mr Pyne, who warned against "lone ranger" doctors disregarding drug company advice, said state medical boards were best placed to investigate patient concerns on prescribing.
But a spokeswoman for the NSW Medical Board said it would only act where prescribing went against recommendations by doctors' professional bodies.
Senior pediatricians in the Royal Australian College of Physicians - which is leading a rewrite of Australia's outdated ADHD guidelines - support the use of Ritalin for preschoolers.
Melbourne ADHD specialist Daryl Efron, who is closely involved in what is expected to be a year-long redrafting, said there was no doubt Ritalin and other methylphenidate products were safe and effective for young children with serious ADHD.
"I would hope that in 15, 18 months from now, when the guidelines are published, we should be able to make a fairly firm statement about the safety and effectiveness of stimulants in children under six," Dr Efron told The Australian.
He acknowledged that Novartis was unlikely to change its position "until we've got a solid body of research to support the impression we as prescribers have - that it's as effective and safe in younger children".
This evidence was emerging from a review by the National Institutes of Health in the US, which had found "these drugs are as effective and as safe, with a similar side-effect profile, in children under six as they are in children over six".
Dr Efron said there was no real safety issue with the drug - which opponents claim makes kids too docile and has been linked to sudden coronary deaths overseas - and challenged the Government to tackle real issues such as more counselling services for ADHD patients and families.
He urged the Government to give pediatricians the ability to refer ADHD children for "critical" free psychological counselling, which would become available this year under a new mental health program within Medicare.