Trends in the consumption of attention deficit hyperactivity disorder medications in Castilla y León (Spain): changes in the consumption pattern following the introduction of extended release methylphenidate

Treceño, C.; Arias, Luis H. Martín; Sáinz, María; Salado, Inés; Ortega, P.; Velasco, Verónica; Bulnes, Natalia Jimeno; Escudero, Antonio; Velasco, A. M.; Carvajal, Alfonso

doi:10.1002/pds.2348

Cited by 44 publications

(39 citation statements)

References 31 publications

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“…Esto es lo que hizo la American Academy of Pediatrics (2011), y tuvo respuesta de la International Society for Ethical Psychology and Psychiatry (2012), que además solicitó la retirada de la recomendación, por no estar basada en pruebas, por existir alternativas más eficaces, y considerar el riesgo de la misma. En España entre los años 2000 y 2012 la prescripción de metilfenidato y atomoxetina en población infantil se multiplicó casi por 30, manteniendo un aumento constante, cuyo repunte coincide con la introducción de una forma de liberación prolongada (Concerta®) (Ver Grafico 2) (Treceño et al, 2012).…”

Section: Dsm-v 2013unclassified

Peculiaridades del Consentimiento Informado en Salud Mental. Considerando el Caso TDA/H como Ejemplo

Eizaguirre¹,

Aróstegui²

2014

Clín. Contemp.

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Resumen. El artículo parte de la consideración de que existe un déficit de consentimiento informado en Salud Mental y se considera el papel que juegan la tradición paternalista, la posible incapacidad del paciente y el paradigma de la Salud Mental basada en la evidencia. El paciente necesita toda la información sobre el significado del diagnóstico, las distintas opciones de tratamiento, y los efectos adversos, en el marco de un proceso clínico prolongado. El consentimiento informado es un proceso, y requiere de un clínico dispuesto a considerar junto al paciente las opciones, incluida el rechazo del tratamiento. El trastorno por déficit de atención e hiperactividad (TDA/H) en menores es usado para ilustrar la situación del consentimiento informado en Salud Mental, analizando la información facilitada en esta área. Se necesitan textos amplios con suficiente información sobre las diferentes opciones de tratamiento, que podrían constituir un banco de datos para el consentimiento informado, usando quizás procedimientos actuales de gestión del conocimiento, Internet y tecnología Wiki. Palabras clave: Consentimiento informado (CI), Principio de autonomía, Diferentes opciones de tratamiento, Resultados clínicos, Salud Mental, Trastorno por déficit atencional e hiperactividad (TDA/H).Abstract. There is a lack of informed consent in Mental Health care. Issues such as the paternalistic tradition, the patient's disability, and the framework of Mental Health based on evidence will be taken into consideration in this regard. Users need to be provided with all the information regarding the meaning of the diagnosis, the different treatment options as well as the possible side effects, in the context of a prolonged clinical process. Informed consent is a process. Users require practitioners who are ready to consider these options together with the patient, including the refusal of treatment. A case of attention deficit disMiguel A. Valverde Eizaguirre en la actualidad es Psicólogo clínico en la

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Section: Dsm-v 2013unclassified

Peculiaridades del Consentimiento Informado en Salud Mental. Considerando el Caso TDA/H como Ejemplo

Eizaguirre¹,

Aróstegui²

2014

Clín. Contemp.

View full text Add to dashboard Cite

show abstract

“…To avoid the influences caused by age structure of the population, the consumption for those children and adolescents >5 and <18 years also was calculated. We have selected the MPH (30 mg), ATX (80 mg) and LDX (30 mg), to N06BA04, N06BA09 and N06BA12 groups of the Anatomical Therapeutic Chemical, using the Defined Daily Doses (DDD) [5]. The total population for each year studied was obtained from the National Statistics Institute (INE).…”

Section: Methodsmentioning

confidence: 99%

“…Each municipality has a wide network of pharmacies and medical center. For the period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001), the databases of the Spanish Ministry of Health has been used, which it was published previously study [6]; and for the period (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) [5,6]. The data were expressed in defined daily doses (DDDs) per 1000 inhabitants per day (DDD/1000 inhabitants/day), using the DDD values proposed by the World Health Organization.…”

Section: Methodsmentioning

confidence: 99%

“…ADHD treatment may require the use of psycho stimulants, like Metilphenidate (MPH) and Lisdexamphetamine (LDX); and not stimulants, like Atomoxetine (ATX), that are the officially drugs approved in Spain [4]. In Spain pharmacotherapy concurred with marketing of extended-release MPH formulation, about 2003-2004 [5]. The aim of this study was to describe trends in ADHD diagnosis, and to estimate the prevalence in Castile-La Mancha (Spain), studying the evolution of drugs consumption.…”

Section: Introductionmentioning

confidence: 99%

“…The actual increased interest in this pathology has been promoted by the increased number of cases and the use of psychostimulants in children, being the most diagnosed behavioral disorder in this age group [1]. Recent meta-analyzes estimate an overall prevalence of 3-7%, being in Spain 6.8%, perhaps for an overdiagnosis or overtreatment [2][3][4][5][6]. ADHD treatment may require the use of psycho stimulants, like Metilphenidate (MPH) and Lisdexamphetamine (LDX); and not stimulants, like Atomoxetine (ATX), that are the officially drugs approved in Spain [4].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimating the Prevalence of Attention Deficit Hyperactivity Disorder in Castile-La Mancha, Spain (1992-2020)

Criado-Álvarez¹,

Romo‐Barrientos²,

González-González³

et al. 2017

IPCDD

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Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged Յ18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included.Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCEThis review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.

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Trends in the consumption of attention deficit hyperactivity disorder medications in Castilla y León (Spain): changes in the consumption pattern following the introduction of extended release methylphenidate

Abstract: There has been an enormous increase in ADHD medication consumption in Castilla y León in the last few years; increase rocketed when extended-release methylphenidate was marketed. A rapid increase in the consumption is a warning on possible overdiagnosis and inappropriate prescription.

Cited by 44 publications

References 31 publications

Peculiaridades del Consentimiento Informado en Salud Mental. Considerando el Caso TDA/H como Ejemplo

Peculiaridades del Consentimiento Informado en Salud Mental. Considerando el Caso TDA/H como Ejemplo

Estimating the Prevalence of Attention Deficit Hyperactivity Disorder in Castile-La Mancha, Spain (1992-2020)

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

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