Written answers

Tuesday, 9 October 2012

Department of Health

Prescription Statistics

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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To ask the Minister for Health if he will provide statistics on the frequency of the prescription of the psychotropic drugs Ritalin and Prozac to persons under the age of 18 years; the criteria used to determine and prescribe these drugs to children and teenagers; the extent of the prescribing; and if he will make a statement on the matter. [43346/12]

Photo of Alex WhiteAlex White (Dublin South, Labour)
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Data on the frequency of prescribing of Ritalin and Prozac are not recorded by the Department or by the Health Service Executive (HSE). The HSE's Primary Care Reimbursement Service (PCRS) maintains a record of prescriptions dispensed under the Community Drugs Schemes. This data does not record the age of the person for whom the prescription was reimbursed nor the condition for which the medicine was prescribed. The PCRS is collating data on the number of prescriptions for these medicines dispensed under the Community Drugs Schemes in 2011 and it will be forwarded to the Deputy as soon as it is received.

In the approved prescribing information, it is stated that the drugs Ritalin and Prozac can be licensed to be prescribed for the indications set out as follows. Prozac (fluoxetine) is indicated in children and adolescents aged 8 years and above for moderate to severe major depressive episode, if depression is unresponsive to psychological therapy after 4–6 sessions. Fluoxetine should be offered to a child or young person with moderate to severe depression only in combination with a concurrent psychological therapy. In children and adolescents aged 8 years and above treatment should be initiated and monitored under specialist supervision. For paediatric patients who respond to treatment, the need for continued treatment after 6 months should be reviewed. If no clinical benefit is achieved within 9 weeks, treatment should be reconsidered.

Ritalin (methylphenidate) is indicated as part of a comprehensive treatment programme for attention-deficit / hyperactivity disorder (ADHD) in children aged 6 years of age and over when remedial measures alone prove insufficient. The prescribing information sets out specific criteria for diagnosis. Treatment must be initiated under the supervision of a specialist in childhood and/or adolescent behavioural disorders. Methylphenidate treatment is not indicated in all children with ADHD and the decision to use the drug must be based on a very thorough assessment of the severity and chronicity of the child’s symptoms in relation to the child’s age. The clinical indications also address the issue of long term (more than 12 months) use in children and adolescents, pre-treatment screening and on-going monitoring. In addition, methylphenidate is tightly controlled under the Misuse of Drugs legislation in recognition of its potential for abuse. These controls include that prescriptions must be handwritten, must be retained by the pharmacist who dispenses it and no instalment may be supplied later than two months after the date of the prescription.

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