According to Israeli Maccabi Kupat Cholim (HMO) pediatrician Dr. Shlomi Antebi, one in five Israeli children are taking Ritalin or Concerta for attention disorders while a secondary condition is undetected and therefore, their true condition is not being treated.
The study monitored 520 children ages 6 to 18 in the central Israel from May 2006 to May 2008. All of the children were receiving medication for attention disorders. The study documented that 70% were diagnosed with ADHD but this was untreated. The coexisting conditions included oppositional defiant disorder (40 percent), mood disorders including depression and behavioral problems (18 percent each), and anxiety and learning disabilities (28 percent each).
25 percent of the patients over 13 admitted to using alcohol and tobacco.
The study concluded that 13.5% of the children should not be on Ritalin or Concerta. In 8% of these cases, the drug therapy was unsuccessful.
Dr. Antebi explains that many doctors are simply unqualified to make the call regarding Ritalin, explaining a diagnoses may only be made by a medical professional who deals with such cases fulltime, not “moonlighting” as he put it.
In accordance with Health Ministry regulations, only neurologists and psychiatrists are supposed to prescribe Ritalin but pediatricians who have certified may as well, but their additional training will usually not include addressing ADHD.
The study, released at a meeting of the Israel Society of Clinical Pediatrics, questions the widespread use of the Test of Variables of Attention for diagnosing attention disorders in children. The computerized test, often abbreviated as TOVA, seeks to measure a patient’s sustained and selective attention to determine whether he or she suffers from an attention disorder.
Dr. Antebi warns that prescribing either drug, Ritalin or Concerta to children who should not be taking the medication may not only prove unsuccessful, but the drug may also exacerbate unwanted side effects. He warns that Ritalin is also tied to stunted growth in patients. Patients on Ritalin must be monitored semi-annually according to Health Ministry guidelines, which include vital signs and growth progress, height and weight of the child.
According to the report, appearing in the daily Haaretz, 2% of Israeli children (about 51,000) are diagnosed with attention problems and some 35,000 Ritalin or Concerta prescriptions are filled annually.
(Yechiel Spira – YWN Israel)