Impact of withdrawal of Ritalin LA in the Western Cape.

To the Editor: In 2008, the regional supply of Ritalin LA (long-acting methylphenidate) to children managed in the government sector was terminated after 2 years of access, returning to the immediate-release formulation. A specialist (FvBD) seeing children at the Red Cross Children’s Hospital and some special schools monitored 57 children with attention deficit hyperactivity disorder (ADHD). By the end of the first term on the immediate-release formulation, 46 (80%) had experienced unfavourable consequences related to medication change. Their academic marks plummeted and they spent more time in detention or being disciplined. Their deterioration in behaviour at home caused additional problems, leading to the parents of 5 children buying Ritalin LA privately. In 2 cases use of Ritalin LA was erratic owing to economic constraints, and the children were at times given the immediate-release formulation. This cohort represented a small proportion of the total number of children in the Western Cape for whom Ritalin was prescribed.