Trends in the prescribing of stimulant medication for the treatment of Attention Deficit Hyperactivity Disorder in children and adolescents in NSW

Salmelainen, Pia

doi:10.1071/nb02s01

Cited by 28 publications

(32 citation statements)

References 48 publications

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“…Our results support the findings of large increases and high levels of consumption of psychostimulants in the US and Australia using a variety of other indicators of psychostimulant consumption, such as prescriptions or tablets dispensed, visits to doctors, and regional or national surveys of young people done in many settings, including schools 1 , 6 . ‐ 14 …”

Section: Discussionmentioning

confidence: 99%

“…Studies on the characteristics of ADHD and psychostimulant use are difficult to compare because of the different units, varying age groups studied and differing methods used 11 . ‐ 14 A lack of standardisation in Australian and international studies underlies the few reported comparisons of regional 8 or international 12 consumption of psychostimulants and hinders the evaluation of prescribing practices and prescription drug misuse.…”

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confidence: 99%

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Licit psychostimulant consumption in Australia, 1984–2000: international and jurisdictional comparison

Berbatis¹,

Sunderland

Bulsara

2002

Medical Journal of Australia

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Objectives: To examine trends in the licit consumption of the psychostimulants dexamphetamine and methylphenidate in Australia and nine other countries from 1994 to 2000 and in each State and Territory of Australia from 1984 to 2000. Design: Annual rates of consumption of psychostimulants were compared using Poisson regression models. All drug consumption was standardised to defined daily doses per 1000 population per day. Main outcome measures: Rates of consumption of each psychostimulant in each country and in each Australian State and Territory. Results: For the 10 countries from 1994 to 2000, total psychostimulant consumption increased by an average 12% per year, with the highest increase from 1998 to 2000. Australia and New Zealand ranked third in total psychostimulant use after the United States and Canada. Australia consumed significantly more than the United Kingdom, Sweden, Spain, the Netherlands, France or Denmark. In Australia, from 1984 to 2000, the rate of consumption of licit psychostimulants increased by 26% per year, with an 8.46‐fold increase from 1994 to 2000. Western Australia ranked first, with nearly twice the consumption rate of total psychostimulants as New South Wales, which ranked second. Methylphenidate is the main psychostimulant consumed in the US and Canada, and dexamphetamine in Australia. Conclusions: The consumption of psychostimulants in Australia is high internationally and varies significantly between States and Territories. The results imply varied jurisdictional prescribing determinants and supply processes throughout Australia, which may require new national prescribing standards and access to online patient data for prescribers and dispensers.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Licit psychostimulant consumption in Australia, 1984–2000: international and jurisdictional comparison

Berbatis¹,

Sunderland

Bulsara

2002

Medical Journal of Australia

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“…The most commonly prescribed stimulants, methylphenidate, and amphetamines experienced a fivefold increase in use from 1987 to 2002 among children in the United States [17]. Similarly, between 1990 and 2000, Australia saw a fivefold increase in the number of children and adolescents with ADHD who had commenced taking stimulant medication [18]. Although stimulants help to effectively manage ADHD symptoms, they are also associated with a number of adverse events: initial insomnia is among the most commonly reported, and is characterized by prolonged sleep onset latency (SOL).…”

Section: Introductionmentioning

confidence: 99%

Melatonin in Youth: N-of-1 trials in a stimulant-treated ADHD Population (MYNAP): study protocol for a randomized controlled trial

Punja

Nikles

Senior

et al. 2016

Trials

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BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neurological disorder affecting 5 % of children worldwide. A prevalent problem for children with ADHD is initial insomnia. The gold standard treatment to manage ADHD symptoms is stimulant medications, which may exacerbate the severity of existing initial insomnia. Currently, no gold standard treatment option exists for initial insomnia for these children. Melatonin, a hormone and a popular natural health product, is commonly provided to children by parents and recommended by healthcare providers, but high quality pediatric evidence is lacking.Methods/designThis trial is a multicenter randomized triple-blind, placebo-controlled, parallel-group, randomized, controlled trial (RCT), in which each participant is offered an N-of-1 trial. An N-of-1 trial is a multiple-crossover, randomized, controlled trial conducted in a single individual. For the N-of-1 trial, each participant will undergo three pairs of treatment/placebo periods; each period is 1 week in length. Half the participants will have melatonin in the first period, the other half will start with placebo, and this will make up the parallel-group RCT. The primary outcome will be mean difference in sleep onset latency as measured by sleep diaries. A comparison of treatment effects yielded by the RCT data versus the aggregated N-of-1 trial data will also be assessed.DiscussionThis trial will provide rigorous evidence for the effectiveness of melatonin in children with ADHD on stimulants who experience initial insomnia. Further, this study will provide the first prospectively planned head-to-head comparison of RCT data with pooled data from a series of N-of-1 trials. Aggregated N-of-1 trials may be a powerful tool to produce high quality clinical trial evidence.Trial registration numbersClinicalTrials.gov, NCT02333149. Registered on 16 December 2014. Australian New Zealand Clinical Trials Registry, ACTRN12614000542695. Registered on 21 May 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1499-6) contains supplementary material, which is available to authorized users.

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“…pharmacological and psychosocial) for children and adolescents diagnosed with ADHD for the best clinical outcomes [1,3,7,8,26-32]. In fact, certain studies have shown that the multidisciplinary approach produces additional benefits in that there is greater satisfaction amongst parents and teachers as this approach leads to lower medication dosages for these children [29,33].…”

Section: Introductionmentioning

confidence: 99%

“…In fact, certain studies have shown that the multidisciplinary approach produces additional benefits in that there is greater satisfaction amongst parents and teachers as this approach leads to lower medication dosages for these children [29,33]. It is well established that ADHD is a multi-factorial disorder, having both psychological and social components, that can have negative outcomes if not diagnosed and managed effectively [1,7,8,26,34-36]. …”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of the Neuro Emotional Technique (NET) for childhood Attention Deficit Hyperactivity Disorder (ADHD): a protocol

Karpouzis

Pollard

Bonello

2009

Trials

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Trends in the prescribing of stimulant medication for the treatment of Attention Deficit Hyperactivity Disorder in children and adolescents in NSW

Cited by 28 publications

References 48 publications

Licit psychostimulant consumption in Australia, 1984–2000: international and jurisdictional comparison

Licit psychostimulant consumption in Australia, 1984–2000: international and jurisdictional comparison

Melatonin in Youth: N-of-1 trials in a stimulant-treated ADHD Population (MYNAP): study protocol for a randomized controlled trial

A randomised controlled trial of the Neuro Emotional Technique (NET) for childhood Attention Deficit Hyperactivity Disorder (ADHD): a protocol

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