Methylphenidate (Ritalin) rejected from the WHO Essential Medicines List due to uncertainties in benefit-harm profile.
The World Health Organization (WHO) just rejected an application to include the ADHD drug methylphenidate (Ritalin) on the Essential Medicines List. Their conclusions were just published in the British Medical Journal and matched many of our observations at Gray Matters:
The WHO systematic review reported that “Methylphenidate may improve teacher and parent reported symptoms, however there were almost no studies on the benefits (and harms) of stimulant medication with a duration above three months”. They wrote “…this is very problematic as ADHD is considered a chronic condition and children are treated for years”. They also noted that amphetamines are also associated with several adverse effects which often lead to its withdrawal.
At Gray Matters we are not opposed to medication. Rather, we support a more selective prescription based on measured brain function – with the confidence this provides that medication will truly improve function. Parent and teacher reports of observed improvements are not enough to conclude that medication is doing more good than harm, and the long-term effects of stimulant medication have not been studied.
Gray Matters has recorded over 10,000 QEEG brain maps – only a tiny fraction of these children and adults would have benefited from ADHD medication. Stimulant medications are based on various formulations of amphetamine. Their use should be considered with a seriousness that reflects the power of these drugs, their side-effects and their possible long-term effects on the brain’s ability to regulate itself.
The WHO report concludes the following: “The existing trials on the benefits and harms of methylphenidate for ADHD have methodological issues. We must improve our clinical research base … with a focus on both benefits and harms. It is also important to control for the adverse effects …of publication bias and to reduce financial conflicts of interests.”