Stimulant and non-stimulant attention deficit/hyperactivity disorder drug use: total population study of trends and discontinuation patterns 2006-2009

Acta Psychiatr Scand. 2013 Jul;128(1):70-7. doi: 10.1111/acps.12004. Epub 2012 Sep 4.

Abstract

Objective: To explore the prevalence and discontinuation of dispensed medications for attention deficit/hyperactivity disorder (ADHD) drugs from 2006 to 2009.

Method: A total population cohort of all individuals aged 6-45 years, alive and registered as residents in Sweden during any calendar year from 2006 to 2009 (N = 5 149 791) included 41 700 patients dispensed with an ADHD drug (methylphenidate, atomoxetine, amphetamine, or dexamphetamine). The dispensing prevalence was calculated for each year, stratified on sex and age. A longitudinal analysis was also performed to compare the rates of treatment discontinuation across the strata.

Results: The dispensing prevalence increased from 2.93 per 1000 in 2006 to 6.98 in 2009 (PR = 2.38, 95% CI = 2.34-2.43). The prevalence ratio (PR) was 3.40 for adults, 22-45 years old; 2.41 for adolescents, 15-21 years old; and 1.90 for children aged 6-14. The increase was also greater in women than in men (PR = 2.92 vs. 2.19). Patients aged 15-21 were the most likely to discontinue treatment; after 3 years and 11 months, 27% of those patients were still under treatment.

Conclusion: From 2006 to 2009, the number of prescriptions dispensed for ADHD drugs increased substantially. The rate of treatment discontinuation in the age interval 15-21 is higher than expected considering the persistence rates of the disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Dopamine Uptake Inhibitors / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Practice Patterns, Physicians' / trends*
  • Prescription Drugs / therapeutic use
  • Prevalence
  • Registries / statistics & numerical data
  • Severity of Illness Index
  • Sweden / epidemiology
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Dopamine Uptake Inhibitors
  • Prescription Drugs