Patients with ADHD (Attention Deficit Hyperactivity Disorder) and psychiatrists are once again calling on the government to revert to branded medication as the current treatment is having a detrimental effect on some children and adults.
Two years ago, patients who reacted poorly to a change in ADHD treatment – from a branded medication to a generic one – were investigated by an inquiry after mental health professionals and parents of children raised the alarm that some were regressing.
The side effects were having an impact on sleeping patters, appetite, aggression and anxiety among others, and the switchover had even seen a person losing their job within three months, Times of Malta has been told.
Consequently, some patients were eventually reverted back from the cheaper generic Xenidate to the branded medication Concerta.
However, since then, a number of new patients who were prescribed Xenidate, and had never been on Concerta before, started reporting similar side effects.
Xenidate is also clinically less effective, and some patients are buying Concerta out of their own pocket because the authorities are not giving them the option to swap to Concerta.
While not all patients on Xenidate are reporting adverse symptoms, ADHD Malta and the Maltese Association of Psychiatry (MAP) are urging the government to allow people to switch to Concerta on the recommendation of their doctor.
Pamela Muscat, president of ADHD Malta, noted that some patients were so desperate that they were paying for Concerta themselves, forking out up to €200 a month depending on the dosage. The cost increased for families where more than one person has been diagnosed with ADHD.
One member of the association who was refused a change in medication despite their doctor’s recommendation was told that the authorities had received too many requests for Concerta, Muscat noted.
Consultant child and adolescent psychiatrist Nigel Camilleri said the Maltese Association of Psychiatry, which he heads, had warned the authorities of the effects that Xenidate was having on some children, and called for the reintroduction of Concerta for new patients.
The psychiatry association, he added, was concerned about a lack of choice for ADHD medication in the country.
Asked if the government planned on reintroducing Concerta for everyone, and not just those who were seen to by the inquiry, a health ministry spokes-person said the matter had been “thoroughly investigated” and the evidence compiled and confirmed with a foreign consultant.
“For the vast majority of patients, Xenidate seems to be
effective in controlling the symptoms of ADHD,” she said.
“This can be shown by the high number of patients on the Xenidate medication through the government service.
“Patients using the government pharmaceutical service, who experienced a negative reaction when switching from Concerta to Xenidate and provided an adverse drug report and a patient assessment report, were re-offered the Concerta brand, as this is being approved on a named patient basis,” she added.
The spokesperson also noted that medical supplies were procured through open tendering procedures in line with public procurement regulations.
“In case there is any adverse reaction with the treatment being supplied, the patient or guardian is to liaise with their doctor in order to raise such an alert for consideration of exceptional treatment,” the ministry spokesperson said.