Department of Health
MEDICINES CONTROL AGENCY
Market Towers 1 Nine Elms Lane London SW8 5NQ
Telephone 0171-273 0600
Facsimile 0171- 273 0737	.
	18 September 1998

Dear Charles,

Thank you for copying to me your letter of 26th August to Professor Rawlins, asking about the increasing use of Ritalin and product information warnings about sudden withdrawal of neuroleptics.

As you say, the product information for Ritalin (methylphenidate) states that it should be used under the supervision of a specialist in childhood behaviour disorders and there is an increasing trend for such specialists to prescribe central nervous system stimulants such as Ritalin. However, decisions regarding prescribing are not a matter for the Medicines Control Agency or the Committee on Safety of Medicines but for the individual physician using his or her clinical judgement, their medical knowledge and experience and their knowledge of the individual patient. The role of the Licensing Authority is to provide information to the prescriber about the safe use of a medicine by means of the authorised product information, in order that they may take this into account when making prescribing decisions. We consider that the product information provided by the manufacturer regarding Ritalin does give such advice.

You also raise the issue of the warnings about withdrawal reactions in product information for neuroleptics. We will look into this issue and comment further to you.

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