Effects of FDA Advisories on the Pharmacologic Treatment of ADHD, 2004–2008

Kornfield, Rachel; Watson, Sydeaka; Higashi, Ashley S.; Conti, Rena M.; Dusetzina, Stacie B.; Garfield, Craig F.; Dorsey, E. Ray; Huskamp, Haiden A.; Alexander, G. Caleb

doi:10.1176/appi.ps.201200147

Cited by 27 publications

(10 citation statements)

References 36 publications

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“…41,42 Others have documented upward trends in ADHD medication treatment despite these safety alerts, which contrast with the downward trends seen in pediatric antidepressant use following alerts regarding suicidality. 41,43,44 Prevalence of ADHD medication use also increased despite an overall downward trend in pediatric medication prescriptions. 45 Notably, there has been an increase in antipsychotic medication use among children, including concomitant use of multiple psychotropic medications, with the most common combination being ADHD medication and an antidepressant.…”

Section: Discussionmentioning

confidence: 99%

Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

Visser

Danielson

Bitsko

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

1,034

822

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Objective Data from the 2003 and 2007 National Survey of Children’s Health (NSCH) reflect the increasing prevalence of parent-reported ADHD diagnosis and treatment by health care providers. This report updates these prevalence estimates for 2011 and describes temporal trends. Method Weighted analyses were conducted with 2011 NSCH data to estimate prevalence of a parent-reported ADHD diagnosis, current ADHD, current medication treatment, ADHD severity, and mean age of diagnosis for US children aged 4–17 years and among demographic subgroups. A history of ADHD diagnosis (2003—2011) as well as current ADHD and medication treatment prevalence (2007–2011) were compared using prevalence ratios and 95% confidence intervals. Results In 2011, 11% of children aged 4–17 years had ever received an ADHD diagnosis (6.4 million children). Among those with a history of ADHD diagnosis, 83% were reported as currently having ADHD (8.8%); 69% of children with current ADHD were taking medication for ADHD (6.1%, 3.5 million children). A parent-reported history of ADHD increased by 42% from 2003—2011. Prevalence of a history of ADHD, current ADHD, medicated ADHD and moderate/severe ADHD increased significantly from 2007 estimates. Prevalence of medicated ADHD increased by 28% from 2007—2011. Conclusions An estimated two million more US children aged 4–17 years had been diagnosed with ADHD in 2011, compared to 2003. More than two-thirds of those with current ADHD were taking medication for treatment in 2011. This suggests an increasing burden of ADHD in the US. Efforts to further understand ADHD diagnostic and treatment patterns are warranted.

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Section: Discussionmentioning

confidence: 99%

Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

Visser

Danielson

Bitsko

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

1,034

822

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“…In one study, treatment visits for dextroamphetamine-amphetamine declined from 36% in 2004 to 24% in 2008. 18 Nevertheless, Emergency Department (ED) visits involving ADHD medications tripled from 2005 to 2010. 19 Similarly, calls related to ADHD medication misuse in teenagers rose by 76% based on data from Poison Control Centers.…”

Section: Introductionmentioning

confidence: 99%

Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants

Chen

Crum

Strain³

et al. 2016

J. Clin. Psychiatry

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Objective Little is known regarding the temporal trends in prescription, nonmedical use and emergency department (ED) visits involving prescription stimulants in the United States. We aimed to examine the three national trends involving dextroamphetamine-amphetamin (Adderall) and methylphenidate in adults and adolescents. Method Three national surveys conducted between 2006-2011 were used: National Disease and Therapeutic Index (NDTI), a survey of office-based practices, National Survey on Drug Use and Health (NSDUH), a population survey of substance use, and Drug Abuse Warning Network (DAWN), a survey of ED visits. Ordinary least square regression was used to examine temporal changes over time and the associations between these three trends. Results In adolescents, treatment visits involving dextroamphetamine-amphetamine and methylphenidate decreased over time; nonmedical dextroamphetamine-amphetamine use remained stable while nonmedical methylphenidate use declined by 54.4% in 6 years. ED visits involving either medication remained stable. In adults, treatment visits involving dextroamphetamine-amphetamine remained unchanged while nonmedical use went up by 67% and ED visits went up by 156%. These three trends involving methylphenidate remained unchanged. The major source for both medications was a friend or relative across age groups; two-thirds of these friends/relatives had obtained the medication from a physician. Conclusions Trends of prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits. Increased nonmedical stimulant use may not be simply attributed to increased prescribing trends. Future studies should focus on deeper understanding of the proportion, risk factors and motivations for drug diversions.

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“…Pharmacotherapy has an essential role in the treatment of ADHD [Kornfield et al, ]. Many studies have documented the efficacy of stimulants (e.g., methylphenidate—MPH, amphetamines) and non‐stimulants (atomoxetine) in reducing ADHD symptoms, as well as improving neuropsychological performance on measure of executive functions [Greenhill et al, ; Blum et al, ].…”

Section: Introductionmentioning

confidence: 99%

ADHD pharmacogenetics across the life cycle: New findings and perspectives

Bruxel

Akutagava-Martins

Salatino-Oliveira

et al. 2014

American J of Med Genetics Pt B

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Attention-deficit/hyperactivity disorder (ADHD) is a complex and heterogeneous disorder, affecting individuals across the life cycle. Although its etiology is not yet completely understood, genetics plays a substantial role. Pharmacological treatment is considered effective and safe for children and adults, but there is considerable inter-individual variability among patients regarding response to medication, required doses, and adverse events. We present here a systematic review of the literature on ADHD pharmacogenetics to provide a critical discussion of the existent findings, new approaches, limitations, and recommendations for future research. Our main findings are: first, the number of studies continues to grow, making ADHD one of the mental health areas with more pharmacogenetic studies. Second, there has been a focus shift on ADHD pharmacogenetic studies in the last years. There is an increasing number of studies assessing gene-gene and gene-environment interactions, using genomewide association approaches, neuroimaging, and assessing pharmacokinetic properties. Third and most importantly, the heterogeneity in methodological strategies employed by different studies remains impressive. The question whether pharmacogenetics studies of ADHD will improve clinical management by shifting from trial-and-error approach to a pharmacological regimen that takes into account the individual variability remains unanswered.

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Effects of FDA Advisories on the Pharmacologic Treatment of ADHD, 2004–2008

Cited by 27 publications

References 36 publications

Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants

ADHD pharmacogenetics across the life cycle: New findings and perspectives

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