ADHD Medication Use in Children and Adults Increased Worldwide

A new AHRQ-funded study showed a sharp increase in the use of attention-deficit/hyperactivity disorder (ADHD) medications in children and adults at 15 participating sites in North America, Asia, Australia, northern Europe and western Europe between 2001 and 2015. In all areas, methylphenidate was the most commonly prescribed drug for ADHD. Researchers found that the prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0.02 percent to 0.26 percent. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0.003 percent and 1.48 percent. Access the abstract of the study, published in The Lancet Psychiatry.

2018 Oct;5(10):824-835. doi: 10.1016/S2215-0366(18)30293-1. Epub 2018 Sep 13.

Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases.

Raman SR1, Man KKC2, Bahmanyar S3, Berard A4, Bilder S5, Boukhris T4, Bushnell G6, Crystal S5, Furu K7, KaoYang YH8, Karlstad Ø7, Kieler H9, Kubota K10, Lai EC11, Martikainen JE12, Maura G13, Moore N14, Montero D15, Nakamura H16, Neumann A13, Pate V6, Pottegård A17, Pratt NL18, Roughead EE18, Macias Saint-Gerons D19, Stürmer T6, Su CC8, Zoega H20, Sturkenbroom MCJM21, Chan EW22, Coghill D23, Ip P24, Wong ICK25.

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Abstract

BACKGROUND:

The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence.

METHODS:

We did a retrospective, observational study using population-based databases from 13 countries and one Special Administrative Region (SAR): four in Asia and Australia, two in North America, five in northern Europe, and three in western Europe. We used a common protocol approach to define study populations and parameters similarly across countries and the SAR. Study populations consisted of all individuals aged 3 years or older between Jan 1, 2001, and Dec 31, 2015 (dependent on data availability). We estimated annual prevalence of ADHD medication use with 95% CI during the study period, by country and region and stratified by age and sex. We reported annual absolute and relative percentage changes to describe time trends.

FINDINGS:

154·5 million individuals were included in the study. ADHD medication use prevalence in 2010 (in children aged 3-18 years) varied between 0·27% and 6·69% in the countries and SAR assessed (0·95% in Asia and Australia, 4·48% in North America, 1·95% in northern Europe, and 0·70% in western Europe). The prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0·02% to 0·26%. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0·003% and 1·48% (0·05% in Asia and Australia, 1·42% in North America, 0·47% in northern Europe, and 0·03% in western Europe). The absolute increase in ADHD medication use prevalence per year ranged from 0·0006% to 0·12%. Methylphenidate was the most commonly used ADHD medication in most countries.

INTERPRETATION:

Using a common protocol and data from 13 countries and one SAR, these results show increases over time but large variations in ADHD medication use in multiple regions. The recommendations of evidence-based guidelines need to be followed consistently in clinical practice. Further research is warranted to describe the safety and effectiveness of ADHD medication in the short and long term, and to inform evidence-based guidelines, particularly in adults.