1 Guidance

1 Guidance

This guidance replaces 'Methylphenidate atomoxetine and dexamfetamine for the treatment of attention deficit hyperactivity disorder in children and adolescents' (NICE Technology Appraisal guidance 13) issued in October 2000.

For details, see 'About this guidance'.

1.1 Where drug treatment is considered appropriate, methylphenidate, atomoxetine and dexamfetamine are recommended, within their licensed indications, as options for the management of ADHD in children and adolescents.

1.2 The decision regarding which product to use should be based on the following:

  • the presence of comorbid conditions (for example, tic disorders, Tourette's syndrome, epilepsy)

  • the different adverse effects of the drugs

  • specific issues regarding compliance identified for the individual child or adolescent, for example problems created by the need to administer a mid-day treatment dose at school

  • the potential for drug diversion (where the medication is forwarded on to others for non-prescription uses) and/or misuse

  • the preferences of the child/adolescent and/or his or her parent or guardian.

1.3 If there is a choice of more than one appropriate drug, the product with the lowest cost (taking into account the cost per dose and number of daily doses) should be prescribed.

1.4 Drug treatment should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis. Continued prescribing and monitoring of drug therapy may be performed by general practitioners, under shared care arrangements.