Tearaway toddlers prescribed ADHD drugs

By Janet Fife-Yeomans
Daily Telegraph
May. 30, 2008

TODDLERS as young as two are being diagnosed with ADHD and prescribed drugs including Ritalin.

Figures obtained by The Daily Telegraph reveal 311 children in NSW aged five and under depend on controversial medication, including 58 four-year-olds and 13 three-year-olds.

Health Department figures show that, nationally, doctors have prescribed ADHD drugs to five toddlers aged only two, despite possible side effects.

The mother of one four-year-old who has been on Ritalin since the age of three said she knew there could be long-term effects but the change in her son's behaviour was worth the risk.

"At first I was hoping he didn't have ADHD and I didn't want to put him on medication but I thought I should give it a go and there has been a big improvement," the single mother of two told The Daily Telegraph.

But the disturbing figures tell only part of the story.

They cover scripts subsidised under the Pharmaceutical Benefits Scheme - only a proportion of the young children on ADHD drugs.

With Australia's ADHD rates among the highest in the world, the federal Department of Health said prescriptions paid for without PBS subsidies "are a significant portion of the total scripts".

It has no corresponding data for them.

The most widely prescribed drugs for the youngest children, according to the figures to March this year, continue to be Ritalin and the longer-lasting associated drug, Concerta, which was added to the PBS last year.

Dexamphetamine is the next most popular while Strattera, a longer-lasting non-stimulant, is less popular and prescribed mainly for children aged six and older.

As well as the three and four-year-olds, there are 240 five-year-olds on subsidised ADHD drugs in NSW. There are 6692 6- to 10-year-olds, 9006 11- to 15-year-old and 2584 16- to 18-year-olds.

The figures follow the State Government's ADHD review which found there was no overprescribing of drugs.

But child psychiatrist Jon Jureidini said he was disappointed at the number of preschoolers on the list.

"I would be confident that they (the drugs) are being inappropriately used in most cases of preschool children," Dr Jureidini said.

"ADHD is not a good explanation for putting these children on drugs.

"I have seen children of that age displaying very disturbed behaviour but it is usually a medical problem or significant family circumstances that are undermining their well-being."

However paediatrician Dr Michael Kohn, the treating doctor for the four-year-old, said he was not surprised at the number of children on ADHD medication.

Dr Kohn, a senior staff specialist in paediatrics at The Children's Hospital at Westmead, said the prescribing of ADHD drugs to children aged four and less was strictly controlled in NSW.

Specialists needed the permission of the state's Stimulant's Committee with the committee having to meet on each individual case.