Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases

Raman, Sudha R.; Man, Kenneth K C; Bahmanyar, Shahram; Bérard, Anick; Bilder, Scott; Boukhris, Takoua; Bushnell, Greta A.; Crystal, Stephen; Furu, Kari; Kao-Yang, Yea Huei; Karlstad, Øystein; Kieler, Helle; Kubota, Kiyoshi; Lai, Edward Chia Cheng; Martikainen, Jaana E.; Maura, Géric; Moore, Nicholas; Montero, Dolores; Nakamura, Hidefumi; Neumann, Anke; Pate, Virginia; Pottegård, Anton; Pratt, Nicole; Roughead, Elizabeth E.; Saint-Gerons, Diego Macías; Stürmer, Til; Su, Chien-Chou; Zoëga, Helga; Sturkenbroom, Miriam C.J.M.; Chan, Esther W.; Coghill, David; Ip, Patrick; Wong, Ian C. K.

doi:10.1016/s2215-0366(18)30293-1

Cited by 231 publications

(236 citation statements)

References 31 publications

Supporting

Mentioning

205

Contrasting

Unclassified

Order By: Relevance

“…This is similar to the U.S. gender rates (Medco 2011). Stimulants were more likely to be prescribed to males at a ratio of 3.79 to 1, a rate similar to that seen in other countries worldwide (Raman et al 2018). This gender difference for stimulant prescription is in line with the gender differences reported for ADHD prevalence in the 2015/16 New Zealand Health Survey (Ministry of Health 2016).…”

Section: Psychotropic Prescription Rates For Nz Youth 91supporting

confidence: 71%

“…The stable rate of anxiolytic and sedative and hypnotic prescription rates found across the 9 years for New Zealand youth reflects the stable prescription trends for these medications reported in other countries such as the United Kingdom, Australia, Denmark, and Iceland (Stephenson et al 2013;John et al 2015;Steinhausen 2015). Stimulant medication prescription increases are above the pooled worldwide average, but sit in the middle of the range of increases (Raman et al 2018).…”

Section: Rates and Trendsmentioning

confidence: 66%

“…The prescription rate of stimulants of 1.06% for New Zealand youth in 2016 is in the lower range of reported rates worldwide, with prescription rates ranging from 0.7% and 0.9% in Western Europe, Asia, and Australia to 4.5% in North America (Raman et al 2018). The limited data on the rates of prescription of anxiolytics, sedatives, and hypnotics to children and adolescents in other countries make it difficult to compare New Zealand with them.…”

Section: Rates and Trendsmentioning

confidence: 86%

“…Stimulants belong to a class of medications that have the most research to support their use in children and adolescents, with a recent meta-analysis and systematic review reporting efficacy for 12 weeks (Cortese et al 2018). Raman et al (2018) found a pooled prevalence rate across 13 countries of 2.0% for youth aged 3-18 years old. Rates of prescription ranged from 0.7% to 0.9% in Western Europe, Asia, and Australia to 4.5% in North America.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Psychotropic Medication Prescription Rates and Trends for New Zealand Children and Adolescents 2008–2016

Barczyk

Rucklidge

Eggleston

et al. 2020

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

Objectives: The prescription of psychotropic medication used to treat psychiatric disorders has increased worldwide over the past two decades and has been discussed widely in the literature; however, limited data have been available for New Zealand. The current article aimed to address this knowledge gap. Methods: Prescription data obtained from The Pharmaceutical Management Agency of New Zealand (PHARMAC) were analyzed to obtain prescription dispensing rates and trends for antidepressants, antipsychotics, anxiolytics, sedatives and hypnotics, and stimulants/attention-deficit/hyperactivity disorder medications for youth aged 0-17 years in New Zealand during 2008-2016, including a gender and ethnicity breakdown for 2016 to provide a ''snapshot'' of prescription demographics. These data sets contained all individual prescriptions dispensed in New Zealand during this time period, alongside a unique encrypted National Health Index number to distinguish individuals and demographic data. Results: In 2016, 2.36% of New Zealand youth, totaling 26,175 individuals, were prescribed at least one psychotropic medication, an increase of 65.03% from 2008. Rate of prescription for youth in 2016 and percentage increase since 2008 for each medication class were as follows: antidepressants: 1.07%, 78.33% increase; antipsychotics: 0.37%, 105.60% increase; anxiolytics: 0.15%, 50% increase; and sedatives and hypnotics: 0.22%, 37.50% increase. Stimulants were prescribed to 1.06% of the population, a 41.33% increase since 2011. In 2016 the number of prescriptions was split roughly equally between males and females, with more males receiving stimulant prescriptions and more females receiving antidepressant prescriptions. Stimulants were the medication most likely to be prescribed to M aori, Pacific, and Middle Eastern/Latin American/African groups, with antidepressants most likely for European and Asian groups. M aori tended to be prescribed medications at rates lower than the general population. Conclusions: Overall, prescription rates and the increase in prescription of psychotropic medication to children and adolescents in New Zealand fall within the mid range compared to other Western countries worldwide.

show abstract

Section: Psychotropic Prescription Rates For Nz Youth 91supporting

confidence: 71%

Section: Rates and Trendsmentioning

confidence: 66%

Section: Rates and Trendsmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Psychotropic Medication Prescription Rates and Trends for New Zealand Children and Adolescents 2008–2016

Barczyk

Rucklidge

Eggleston

et al. 2020

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

show abstract

“…Medication adherence rates are low in patients with ADHD [17]. The global increase in the utilization of central stimulant medications (methylphenidate and amphetamine), with the potential of abuse, misuse, and diversion of the drugs, highlights the importance of monitoring medication adherence to minimize these risks but also to optimize prescription [4]. Therapeutic drug monitoring (TDM) is an established concept of quantification and interpretation of drug concentrations in biological fluids (most often in whole blood, plasma, or serum) to guide individualized dosing and for monitoring medication adherence [18,19].…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of methylphenidate and ritalinic acid in plasma correlations with exhaled breath and oral fluid in healthy volunteers

Arvidsson

Beck

Ackehed

et al. 2019

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Purpose The primary aim of this study was to explore the potential of alternative sampling matrices for methylphenidate by assessing the correlations between dl-threo-methylphenidate and dl-threo-ritalinic acid concentrations in exhaled breath and oral fluid with those in plasma, in repeated samples collected after a single oral dose of methylphenidate. The secondary aim was to study the enantioselective pharmacokinetics of methylphenidate in plasma, with a focus on interindividual variability in the metabolism of methylphenidate to ritalinic acid. Methods Twelve healthy volunteers received a single oral dose of dl-threo-methylphenidate (Ritalin® capsules, 20 mg). Venous blood samples were collected for 24 h, and plasma analyzed for threo-enantiomers of methylphenidate and ritalinic acid with LC-MS/MS. Repeated sampling of exhaled breath, using a particle filter device, and of non-stimulated oral fluid, using a felt pad device, was also performed. Exhaled breath and oral fluid were analyzed with a non-enantioselective LC-MS/MS method for dlthreo-methylphenidate and dl-threo-ritalinic acid. Results In all subjects, d-threo-methylphenidate was detectable in plasma for at least 15 h after the dose with a biphasic profile. lthreo-Methylphenidate was measurable in only five subjects and in most cases in low concentrations. However, one female subject displayed a biphasic concentration-time profile for l-threo-methylphenidate. This subject also had the highest d-threo-methylphenidate AUC (191 ng*h/mL versus 32-119 ng*h/mL in the other subjects). d-threo-Ritalinic acid concentrations were on average 25-fold higher (range 6-126) than the corresponding d-threo-methylphenidate concentrations. Single-time point plasma concentration ratios between d-threo-ritalinic acid and d-threo-methylphenidate 1.5-12 h after dose correlated highly (r = 0.88-0.98) with the d-threo-ritalinic acid AUC/d-threo-methylphenidate AUC ratio. In eleven subjects, dl-threo-methylphenidate in oral fluid mirrored the biphasic profile of methylphenidate (sum of dand l-threo-enantiomers) in plasma, but the concentrations in oral fluid were on average 1.8 times higher than in plasma. dl-threo-Methylphenidate was detected in exhaled breath in all subjects, but there was no consistent concentration-time pattern. Conclusions In some subjects, the pharmacologically less active l-threo-enantiomer may contribute to the total plasma methylphenidate concentrations. Monitoring methylphenidate concentrations without enantiomeric determination carries the risk of missing such subjects, which might affect how the plasma concentrations of methylphenidate are interpreted and used for clinical decision making. The use of exhaled breath and oral fluid to assess medication adherence to MPH in patients with ADHD warrants further studies.

show abstract

Association Between Prenatal Exposure to Antipsychotics and Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Preterm Birth, and Small for Gestational Age

Wang¹,

Chan

Coghill

et al. 2021

JAMA Intern Med

Self Cite

View full text Add to dashboard Cite

The risk of birth and neurodevelopmental complications with prenatal exposure to antipsychotics is unclear.OBJECTIVE To evaluate the association between prenatal antipsychotics exposure and the risk of birth and neurodevelopmental problems. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study included children born between January 2001 and January 2015 with follow-up to December 2019 who were identified by the Hong Kong Clinical Data Analysis and Reporting System. Pregnancies with maternal antidepressant/lithium exposure were removed. Primary analyses compared gestationally exposed and gestationally nonexposed individuals with propensity score fine stratification. Additional analyses included gestationally exposed individuals vs those with past exposure and a sibling-matched analysis to evaluate the effect of confounding by indication.EXPOSURES Prenatal antipsychotic exposure. MAIN OUTCOMES AND MEASURESPreterm birth (<37 gestational weeks), small for gestational age (birth weight <2 standard deviations below the mean for gestational age), and first diagnosis of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children. RESULTSThe cohorts included 333 749 mother-child pairs for ADHD (mean [SD] maternal age at delivery, 31.46 [5.03] years) and 411 251 pairs for ASD, preterm birth, and small for gestational age analyses (mean [SD] maternal age at delivery, 31.56 [5.01] years). There were 13 196 children (3.95%) with a diagnosis of ADHD, 8715 (2.12%) with ASD, 33 891 (8.24%) preterm, and 7009 (1.70%) who were small for gestational age. The weighted hazard ratio (wHR) was 1.16 (95% CI, 0.83-1.61) for ADHD and 1.06 (95% CI, 0.70-1.60) for ASD, while the weighted odds ratio (wOR) was 1.40 (95% CI, 1.13-1.75) for preterm birth and 1.36 (95% CI, 0.86-2.14) for small for gestational age when comparing gestationally exposed with gestationally nonexposed individuals. Additional analyses showed no association when comparing gestationally exposed individuals with those with past exposure

show abstract

Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases

Abstract: None.

Cited by 231 publications

References 31 publications

Psychotropic Medication Prescription Rates and Trends for New Zealand Children and Adolescents 2008–2016

Psychotropic Medication Prescription Rates and Trends for New Zealand Children and Adolescents 2008–2016

Pharmacokinetics of methylphenidate and ritalinic acid in plasma correlations with exhaled breath and oral fluid in healthy volunteers

Association Between Prenatal Exposure to Antipsychotics and Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Preterm Birth, and Small for Gestational Age

Contact Info

Product

Resources

About