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'Struggling' GPs demand enhanced service for Ritalin

GPs are calling for the prescription of methylphenidate (Ritalin) to follow other shared-care drugs like warfarin in becoming an enhanced service, following evidence of increasing confusion over the split of responsibilities.

Continuing to prescribe and monitor the drug, which is initiated in secondary care, requires expertise outside day-to-day practice and creates extra workload, GPs claim.

Dr Chaand Nagpaul, a member of the GPC prescribing sub-committee, said it was vital to recognise that when GPs sign prescriptions under shared-care agreements they are taking responsibility for clinical management.

'The principle is that any drug normally prescribed by a specialist should be part of enhanced service,' he said. 'This isn't part of day-to-day practice.'

Calls for the drug to be designated an enhanced service came as experts told a BNF conference on prescribing for children that diagnosis of

ADHD and dose titration of methylphenidate were difficult.

With even paediatric specialists undecided over when and how methylphenidate should be used, GPs said it was hardly surprising they struggled with prescribing the drug.

GPs also revealed they were coming under pressure to continue prescribing it from parents worried about losing Government benefits should their child no longer be regarded as sufficiently disabled.

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