Utilization of Pharmacologic Treatment in Youths with Attention Deficit/Hyperactivity Disorder in Medicaid Database

Winterstein, Almut G.; Gerhard, Tobias; Shuster, Jonathan J.; Zito, Julie Magno; Johnson, Michael R.; Liu, Huazhi; Saïdi, A.

doi:10.1345/aph.1k143

Cited by 113 publications

(102 citation statements)

References 20 publications

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“…40 In retrospective studies, stimulant persistence ranged from 59% at 4 months to 12%-43% at the end of 1 year. 10,13,[41][42][43] Antipsychotics might help to improve persistence to stimulant treatment through control of psychiatric comorbidities or behavioral symptoms of ADHD. 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.…”

Section: Predictors Of Concomitant Use Of Antipsychotics and Stimulanmentioning

confidence: 99%

“…16,17,43,[57][58][59][60][61] Demographic characteristics such as age and gender were used as predisposing factors. Age at the index date (6-12 years and 13-16 years) and gender (male, female) …”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…This finding is consistent with the previous literature and could be attributed to behavioral symptoms of ADHD among boys. 7,8,10,42,43,66,67 Various enabling factors such as region, year of cohort entry in the study, season of index LAS prescription, physician specialty, and health insurance coverage were important predictors of concomitant use of LAS and AAPs. When compared with the eastern region, ADHD youth residing in other regions had a lower likelihood of concomitant use of LAS and AAPs.…”

Section: Predictors Of Concomitant Use Of Antipsychotics and Stimulanmentioning

confidence: 99%

“…Previous literature suggests racial disparities in the concomitant use and persistence of psychotropic medications in ADHD children. 7,8,43,66,73,92 Information on these variables would have provided a better understanding of the factors affecting concomitant use of LAS and AAPs and persistence of LAS medications. Future studies should investigate this matter using other databases.…”

Section: Limitationsmentioning

confidence: 99%

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

Bali

Kamble²,

Aparasu³

2015

JMCP

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Section: Predictors Of Concomitant Use Of Antipsychotics and Stimulanmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Predictors Of Concomitant Use Of Antipsychotics and Stimulanmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

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

Bali

Kamble²,

Aparasu³

2015

JMCP

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“…In addition to the increase in the incidence of ADHD over time, the prevalence could potentially reflect increased diagnosis of ADHD in recent years [4,12]. This may also explain the apparent variability of estimates in various settings and the increased diagnosis rates in Western countries, especially the USA [4,13,14].…”

Section: Introductionmentioning

confidence: 99%

Demographic trends in ADHD diagnosis in U.S. children using NHANES data between 2004 and 2012

Zamil¹,

Wang²,

Vadhariya³

et al. 2017

J Behav Health

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Background: Attention deficit hyperactivity disorder (ADHD) is the most common mental disorder in the pediatric population and affects education, finances, and medication. ADHD diagnostic criteria and resultant prevalence rates are also of special interest to the global psychiatric community. ADHD diagnosis rates and the corresponding demographic distributions through different years are thus an issue of great public health concern and debate. The objective of this study is to characterize changes in the demographic distribution of ADHD diagnosis from 2004 to 2012 in the United States. Methods: ADHD diagnosis data was extracted from the National Health and Nutrition Examination Survey (NHANES) Summary Health Statistics for United States Children, a source of nationally representative data on children in the United States. The ADHD cases were identified based on ICD9-CM diagnosis codes. Chi-square tests were used to investigate differences in ADHD diagnosis rates by demographic characteristics (age, race, and gender) within each year and simple linear regression was applied to determine the extent of change over time. Results: The ADHD diagnosis rate was higher among males, whites, and school-aged children and adolescents (vs. preschoolers aged 3-4) in each year examined. The total number of ADHD cases as well as all demographic groups with the exception of African Americans and preschoolers aged 3-4 exhibited an increasing trend between 2004 and 2012. Conclusions: ADHD diagnosis among youth showed a significant increase in the United States between 2004 and 2012. Notable increases and group differences were also observed among demographic subgroups. These findings indicate a need for future research in reasons for such group differences as well as treatment differences.

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Common and Unique Therapeutic Mechanisms of Stimulant and Nonstimulant Treatments for Attention-Deficit/Hyperactivity Disorder

Schulz

Fan²,

Bédard³

et al. 2012

Arch Gen Psychiatry

100

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CONTEXT Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and impairing psychiatric disorder that affects both children and adults. There are Food and Drug Administration-approved stimulant and nonstimulant medications for treating ADHD; however, little is known about the mechanisms by which these different treatments exert their therapeutic effects. OBJECTIVE To contrast changes in brain activation related to symptomatic improvement with use of the stimulant methylphenidate hydrochloride vs the nonstimulant atomoxetine hydrochloride. DESIGN Functional magnetic resonance imaging before and after 6 to 8 weeks of treatment with methylphenidate (n = 18) or atomoxetine (n = 18) using a parallel-groups design. SETTING Specialized ADHD clinical research program at Mount Sinai School of Medicine, New York, New York. PARTICIPANTS Thirty-six youth with ADHD (mean [SD] age, 11.2 [2.7] years; 27 boys) recruited from randomized clinical trials. MAIN OUTCOME MEASURES Changes in brain activation during a go/no-go test of response inhibition and investigator-completed ratings on the ADHD Rating Scale-IV-Parent Version. RESULTS Treatment with methylphenidate vs atomoxetine was associated with comparable improvements in both response inhibition on the go/no-go test and mean (SD) improvements in ratings of ADHD symptoms (55% [30%] vs 57% [25%]). Improvement in ADHD symptoms was associated with common reductions in bilateral motor cortex activation for both treatments. Symptomatic improvement was also differentially related to gains in task-related activation for atomoxetine and reductions in activation for methylphenidate in the right inferior frontal gyrus, left anterior cingulate/supplementary motor area, and bilateral posterior cingulate cortex. These findings were not attributable to baseline differences in activation. CONCLUSIONS Treatment with methylphenidate and atomoxetine produces symptomatic improvement via both common and divergent neurophysiologic actions in frontoparietal regions that have been implicated in the pathophysiology of ADHD. These results represent a first step in delineating the neurobiological basis of differential response to stimulant and nonstimulant medications for ADHD.

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Utilization of Pharmacologic Treatment in Youths with Attention Deficit/Hyperactivity Disorder in Medicaid Database

Cited by 113 publications

References 20 publications

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

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

Demographic trends in ADHD diagnosis in U.S. children using NHANES data between 2004 and 2012

Common and Unique Therapeutic Mechanisms of Stimulant and Nonstimulant Treatments for Attention-Deficit/Hyperactivity Disorder

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