Comparative Treatment Patterns, Resource Utilization, and Costs in Stimulant-Treated Children with ADHD Who Require Subsequent Pharmacotherapy with Atypical Antipsychotics Versus Non-Antipsychotics

Abstract

BACKGROUND: Although not indicated for attention-deficit/hyperactivity disorder (ADHD), atypical antipsychotics (AAPs) are commonly prescribed for children with ADHD. The treatment patterns, resource utilization, and costs associated with AAPs relative to non-antipsychotic medications have not been evaluated for children with ADHD.

Predictors of Concomitant Use of Antipsychotics and Stimulants and Its Impact on Stimulant Persistence in Pediatric Attention Deficit Hyperactivity Disorder

“…45 This study did not find any difference in the persistence of the index stimulant between ADHD children treated with AAPs and and those treated with non-antipsychotics. 45 However, the impact of the concomitant use of AAPs on the persistence of LAS therapy is largely unknown. This information could help clinicians in improving treatment persistence and subsequent outcomes among ADHD patients.…”

“…On the other hand, the use of AAPs might lead to reduced efficacy of stimulants due to their opposite mechanism of action on the dopaminergic system. 6,44 A study by Sikirica et al (2012) looked at the treatment patterns, resource utilization, and costs in ADHD children treated with AAPs when compared with non-antipsychotic medications. 45 This study did not find any difference in the persistence of the index stimulant between ADHD children treated with AAPs and and those treated with non-antipsychotics.…”

“…6,44 A study by Sikirica et al (2012) looked at the treatment patterns, resource utilization, and costs in ADHD children treated with AAPs when compared with non-antipsychotic medications. 45 This study did not find any difference in the persistence of the index stimulant between ADHD children treated with AAPs and and those treated with non-antipsychotics. 45 However, the impact of the concomitant use of AAPs on the persistence of LAS therapy is largely unknown.…”

“…In contrast to the present finding, Sikirica et al (2012) did not find any difference in the discontinuation rate of index stimulant between ADHD children treated with AAPs and non-antipsychotics. 45 This could be due to difference in study population and other methodological differences. Concomitant use involving antipsychotic and stimulant medications might be needed to treat comorbid psychiatric and behavioral disorders, such as ADHD and disruptive behavioral disorders.…”

Methodological Considerations in Estimating Adherence and Persistence for a Long-Acting Injectable Medication

“…As suggested in prior publications, Kaplan-Meier curves were used to visualize time to discontinuation. 26,27 No adjustments were made for multiplicity or for differences in baseline characteristics between cohorts. All reported P values are from 2-sided hypothesis tests, and statistical significance was defined at the 0.05 level.…”