Magazine article Clinical Psychiatry News

Use of Stimulants for ADHD Still on Rise

Magazine article Clinical Psychiatry News

Use of Stimulants for ADHD Still on Rise

Article excerpt


Patient age plays a large role in changes over time to stimulant use for treatment of attentiondeficit / hyperactivity disorder, according to a study of survey data from 1996 to 2008. Differences in ethnicity, insurance status, and geographic location also were associated with significant differences in use of these medications.

Reported stimulant use among children and adolescents in the United States grew significantly between 2.4% in 1996 and 3.5% in 2008. Researchers reported a 3.4% annual overall increase behind this slow and consistent increase in use of methylphenidate, dexmethyl-phenidate, pemoline, amphetamines, and/or dextroamphetamine.

An estimated 2.8 million children and teenagers reported use of one or more of these stimulant agents in 2008, according to an advance online report of the findings (Am. J. Psychiatry 2011 [Epub doi: 10.1176/appi.ajp.2011.11030387]). Adolescents accounted for the greatest increase in use of stimulants for attentiondeficit/hyperactivity disorder (ADHD), from 2.3% in 1996 to 5.0% in 2008, or an annual increase of 6.5%.

"The continuous, steep increase in stimulant utilization in adolescents likely reflects the recent realization that ADHD tends to persist in puberty, causing significant functional impairment," wrote study authors Samuel H. Zuvekas, Ph.D., and Dr. Benedetto Vitiello.

They evaluated data from the annual, nationally representative MEPS (Medical Expenditure Panel Survey). The MEPS includes data on prescription drug use directly from household respondents and from pharmacies that they reported using during the survey

Stimulant use remained the highest among children aged 6-12 years old, with no significant change during the study period. For example, 4.2% in this age group reported use in 1996 vs. 5.1% in 2008.

In contrast, stimulants were seldom used in children younger than 6 years during the duration of the study and dropped to very low rates in more recent years, the study reveals. Reported use toggled between 0.3% and 0.4% in the years from 1996 to 2003, and thereafter remained at 0.1% each year up until 2008.

Boys continue to use stimulants at a rate approximately three times greater than girls (5.3% vs. 1.6% in 2008, for example), a ratio that did not significantly change between 1996 and 2008.

Ethnicity, however, did account for some variation in ADHD treatment use. Although use overall increased among children from racial and ethnic minority groups, it remained lower than rates for non-Hispanic white children. For example, in 2008 4.4% of white children reported stimulant use, compared with 3.0% of black and 2.1% of Hispanic children.

These differences could be explained, in part, because parents of black or Hispanic children are less likely to report ADHD, compared with parents of white children, the authors noted. …

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