German Insurer Warns of Steep Rise in Ritalin Use Mon Jan 27, 2:21 PM ET By Ned Stafford BERGISCH GLADBACH (Reuters Health) - The head of one of Germany's major public health insurance providers has warned of an "alarming increase" of prescriptions in Germany of the stimulant Ritalin for children and youth. [Fred A. Baughman Jr., MD:
Rolf Stuppardt, chief executive of the public health insurance provider IKK, said that Ritalin (methylphenidate), which is used to treat attention-deficit/hyperactivity disorder (ADHD), is being given to a portion of children and youths who are falsely diagnosed as having ADHD. [Fred A. Baughman Jr., MD:
In a statement released Friday, Stuppardt demanded that only doctors with "special qualifications" be allowed to diagnosis ADHD and prescribe Ritalin. [Fred A. Baughman Jr., MD:
Stuppardt's demands were based on an IKK report co-written by Stephan T. Simon, a pharmacist at the IKK, which covers about 4.4 million people and is headquartered in Bergisch Gladbach. Simon told Reuters Health Monday that as many as 50% of German children and youths taking Ritalin might have been misdiagnosed as having ADHD. [Fred A. Baughman Jr., MD:
The latest statistics for German use of methylphenidate are for 2000, when doctors prescribed 13.5 million doses, Simon said. That compares with 400,000 doses in 1991. [Fred A. Baughman Jr., MD:
National statistics for 2001 and 2002 are not yet available. But Simon said that the number of daily methylphenidate doses covered by the IKK jumped 144% from the first quarter of 1999 to the first quarter of 2001. He believes national usage would be similar to the sharp rise seen at the IKK. Simon said that in the past few years German general practitioners who are not trained in the diagnosis of ADHD have nonetheless increasingly diagnosed children as having ADHD and prescribed Ritalin [Fred A. Baughman Jr., MD:
. He supports Ritalin for treatment of children and youths properly diagnosed as having ADHD but believes the drug treatment should be accompanied with therapy. [Fred A. Baughman Jr., MD:
Simon said he is concerned that some of the symptoms of ADHD could be similar to normal, but difficult, phases that occur when children are growing up. Children improperly diagnosed as having ADHD might, as adults, believe there is a drug for every problem, he said. He blames the US medical community and what he calls its inclination to over-prescribe drugs for helping trigger the increase of Ritalin prescriptions in Germany. "This is coming over like waves from America," he said. [Fred A. Baughman Jr., MD:
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