Britain’s National Institute for Health and Clinical Excellence (NICE) new treatment guidelines for attention-deficit hyperactivity disorder (ADHD) suggest that drugs should be used as first line therapy only for those who are severely impaired.
British physicians are strongly encouraged to implement the NICE recommendations, but they are not obligated to do so. Widespread adoption of the new guidelines would result in dramatic reductions in the use of Ritalin (Novartis) Concerta (Johnson & Johnson) and Strattera (Eli Lilly).
The NICE recommendations call for group-based parent education and training programs as the first line intervention for children with mild or moderate impairment due to ADHD. These behavioral/social interventions are also recommended, along with drug therapy, for severe cases.
NICE also stated that primary care physicians should neither diagnose ADHD nor start drug treatment on their own. These decisions should be left with psychiatrists, pediatricians or those having expertise in ADHD.
Approximately 3% of all school aged children are thought to have ADHD, but only a small percentage of them are severely impaired. In the US, more than 2.5 million children take drugs for ADHD.