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[sSRI-Research] Ritalin Doctor Faces Striking Off

 

http://scotlandonsunday.scotsman.com/health.cfm?id=b892004

 

Sun 18 Jan 2004

Doctor in child drug treatment row to face GMC

 

TOM CURTIS

HEALTH CORRESPONDENT

 

A DOCTOR who used controversial drug treatments on a hyperactive Scots child

could be struck off after being accused of putting patients¹ health at risk.

 

Dr Patrick Cosgrove, a leading advocate of medication to curb hyperactive

behaviour, is due to appear before the General Medical Council tomorrow

accused of serious professional misconduct.

 

The case is thought to be the first of its kind in the UK and could have

important implications both for the treatment of children with Attention

Deficit Hyperactivity Disorder (ADHD) and for the use of drugs on patients

below the age for which they are licensed.

 

Cosgrove, a consultant child and adolescent psychiatrist who runs a private

clinic in Bath, faces five allegations surrounding his practice. His name

could be removed from the medical register if the GMC, which deals with

complaints against doctors in the UK, finds against him.

 

The GMC said he was accused of " acting irresponsibly " in his monitoring of

two patients receiving treatment for ADHD.

 

It is also claimed he failed to provide appropriate advice regarding a

patient¹s treatment to his GP, failed to conduct an appropriate examination

of a patient and failed, in response to a request by a mental health NHS

trust, to release a patient¹s medical records.

 

In addition, it is alleged that on a number of occasions he made

" unprofessional and unsustainable statements " about other doctors involved

in the treatment of his patients which were " likely to cast doubt on their

knowledge and skills " .

 

One parent due to give evidence at the hearing in Manchester is Liz Thompson

from Glasgow, who said her son Anthony was one of Cosgrove¹s patients for

three years from the age of 10. Anthony had behavioural problems from the

age of four but a succession of doctors in Scotland failed to find either a

final diagnosis or an effective treatment.

 

Thompson said she later realised his symptoms appeared to match those of

ADHD, which makes children constantly fidgety, easily distracted and

impulsive, as well as abusive and sometimes violent.

 

A support group then put her in touch with Cosgrove, who was already

well-known for treating ADHD patients and has previously stated that he

believes falling crime rates are the result of tackling the condition with

drugs.

 

Thompson claimed Cosgrove diagnosed ADHD within 25 minutes, without speaking

to or examining her son, and immediately gave her a prescription for

Ritalin, a stimulant now in common use to treat the condition. She said once

her son started taking the drug he stopped eating and sleeping properly, so

she contacted Cosgrove again.

 

She claimed he prescribed a second drug, Risperidone, which is used to treat

schizophrenia. Anthony took both drugs for three years, during which he was

initially less disruptive but Thompson claimed he appeared to be " doped up " .

 

When his behaviour began to deteriorate again, she sought help from the

Overload Network, an Edinburgh-based charity which campaigns on behalf of

ADHD sufferers and their parents.

 

The organisation recommended Thompson received a second opinion and a

psychiatrist in Glasgow weaned her son off both drugs.

 

Overload then complained to the GMC about Cosgrove in relation both to

Thompson and another parent of a hyperactive child he treated. More than

three years after the first complaints, the GMC eventually decided to

convene tomorrow¹s hearing. Thompson said: " When I first went to see Dr

Cosgrove I thought he was a godsend - the answer to all my prayers.

 

" I asked if Anthony still needed help along with the drugs and he said he

would not need any whatsoever, that these drugs would take away any of the

problems he had been experiencing. Nothing could be further from the truth. "

 

She claimed Cosgrove never recommended that Anthony had tests to check how

his body was dealing with the medication. Now 17, her son still has

psychological problems, which she believes were masked but not treated by

the drugs.

 

Janice Hill, of Overload, said she hoped the case would highlight the need

to curb drug treatment for children with psychological problems.

 

Overload claims doctors write out prescriptions for Ritalin and other drugs

far too readily, without trying alternative treatments such as altering diet

or behavioural therapy.

 

US drug company Janssen, which markets Risperidone under the name Risperdal,

says it is indicated for use only in schizophrenia and manic depression.

 

It is thought an adverse judgment against Cosgrove could make it more

difficult for psychiatrists to prescribe such drugs " off-label " in the

future.

 

FOR ADULTS ONLY?

 

MANY UK doctors routinely give patients under the age of 18 medicines that

have been approved only for adults.

 

Seven out of 10 children prescribed a drug in the UK are given a substance

that has not been officially approved for them, including psychiatric

medicines, hormones, painkillers, sedatives and asthma treatments.

 

Growing concern about the issue could see pharmaceutical companies forced by

the European Union to carry out clinical trials to check that all medicines

given to children are suitable for them. New legislation could be introduced

within two years.

 

The Department of Health said that in hospital intensive-therapy units up to

90% of children are given a drug which is either not licensed for them or is

supposed to be used in a different dose or form or given only to older

children.

 

In normal hospital units the figure is between 36% and 67% of children. Even

in GPs¹ surgeries it is estimated at between 22% and 56%.

 

The situation has arisen because very few drugs have been through clinical

trials involving children.

 

On top of the difficulty of getting permission to test on children, drug

companies have little incentive to get involved because children generally

offer only a small market for a medicine.

 

SSRI-Research/

 

 

 

 

 

 

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