Treating children who have Attention Deficit
Hyperactivity Disorder (ADHD) with drugs is not effective
in the long-term, research has shown.
Drugs such as Ritalin and Concerta work
no better than therapy after three years of treatment.
The findings by an influential US study
also suggested long-term use of the drugs could stunt
children's growth.
It said that the benefits of drugs had
previously been exaggerated.
The Multimodal Treatment Study of Children
with ADHD has been monitoring the treatment of 600 children
across the US since the 1990s.
'Exaggerated impact'
Most of the estimated 500,000 children
in Britain with ADHD receive no treatment at all.
But of those that do, most - about 55,000
last year - are prescribed stimulants like Ritalin and
Concerta.
The cost of these drugs to the NHS is
about £28m.
In 1999, the American study concluded
that after one year medication worked better than behavioural
therapy for ADHD.
This finding influenced medical practice
on both sides of the Atlantic, and prescription rates
in the UK have since tripled.
But now after longer-term analysis, the
report's co-author, Professor William Pelham of the University
of Buffalo, said: "I think that we exaggerated the beneficial
impact of medication in the first study.
"We had thought that children medicated
longer would have better outcomes. That didn't happen
to be the case.
"There's no indication that medication's
better than nothing in the long run."
Prof Pelham said there were "no beneficial
effects" of medication and the impact was seemingly negative
instead.
"The children had a substantial decrease
in their rate of growth so they weren't growing as much
as other kids both in terms of their height and in terms
of their weight," he said.
Aggressive behaviour
The Panorama programme features disturbing
footage of a 14-year-old from Stoke-on-Trent, who has
been on ADHD medication for a decade.
Craig Buxton's family kept a video diary
of his behaviour and captured on camera examples of just
how explosive his behaviour can be.
He has self-harmed, suffers night terrors
and is aggressive - he recently assaulted three school
teachers.
His mother Sharon said things had gone
from bad to worse.
"He has broke down and cried when he
gets into situations," she said.
"He says: 'Why am I like this mum, I
don't want to feel like this, I don't want to be like
this, you know, help me'.
"And all I can do is go back to the doctors
and say: 'Is there anything more you can do?'
"All they say is, well, we are doing
what we can."
The National Institute for Clinical Excellence
is currently revising the treatment guidelines for ADHD.
Chair of the working group Dr Tim Kendall
said they were devising a strategy which was likely to
involve training for parents as well as "behavioural interventions".
"The important thing is that we have
an approach which doesn't focus just on one type of treatment,"
Dr Kendall said.