Hawke's Bay ADHD drug use rises by a third

Ritalin and Rubifen - two of the most common drugs used by those with ADHD. Photo/File

Prescriptions of ADHD medication are on track to have increased by more than 50 per cent in four years in Hawke's Bay.

A senior clinical psychologist says the increase shows a need to rethink how attention deficit cases are treated.

The neurodevelopmental Attention Deficit Hyperactivity Disorder (ADHD) is characterised by attention difficulties and behaviour troubles, among other symptoms, and is mostly found in children and adolescents.

New figures released by government drug buying agency Pharmac showed a 33 per cent increase in prescriptions for ADHD medication in Hawke's Bay in the three years to 2016, with 5875 being issued last year.

The financial half year figures for 2017 showed numbers were on track to be 56 per cent higher than in 2013.

Researchers said an increasing awareness of the disorder, a willingness to prescribe drugs as a primary option and a lower threshold for diagnosing ADHD were behind the growth in prescriptions.

Hawke's Bay District Health Board said the increase in prescriptions was positive and meant more people with the disorder were being treated accordingly.

However, Dr Julia Rucklidge, professor of clinical psychology at the University of Canterbury, said a general medication-heavy approach to mental illness needed to be reconsidered.

"We've got an increasing number of people with mental illness... We've got increasing rates of prescriptions... If the treatment was really working, rates of mental illness should be going down, but it's not.

"If it was cancer, and the rates of cancer were going up with the treatment, wouldn't we all say 'hold on, that's not good?'

"Why aren't we having the same conversations with mental illness?"

Dr Philip Moore, Hawke's Bay District Health Board's clinical director for community, women and children, said the increase in prescriptions reflected better services offered by the health board.

"ADHD is a complex condition and often accompanied by other diagnoses," he said.

"Many of the children are helped enormously by expert prescription of appropriate medication.

"However, just as important is our continual monitoring of these patients, some of whom medications are stopped if we do not see any benefit."

He said less than a third of children referred with possible ADHD were diagnosed as a result.

"HBDHB does not believe any increase in children diagnosed is cause for concern.

"Rather, any increase is a direct reflection of our improved service provision.

"HBDHB has worked hard to increase available appointments and develop a specialist service for the most complex children."

University of Otago childhood ADHD researcher Dr Dione Healey said significant prescription increases around the country in the last few years were surprising considering the medical community has been well aware of ADHD for the last 10 or 15 years.

She said the latest international guidelines published in 2013 lowered the threshold for ADHD to be diagnosed, which may have driven the increase in prescriptions.

Dr Healey also urged caution against medicating as a panacea, but noted other methods of treatment, including teacher aides and behavioural management, were resource-heavy.

"The reality of life is that they required a lot of time and resources that are not available due to finances. So medication is a quicker, easier option."

The most common brand name ADHD drugs were Ritalin, Rubifen and Concerta, all containing the active ingredient methylphenidate hydrochloride.