ADHD Medications are on the rise among adults, finds study

Covid-19 put a halt to lot of things going on in busy lifestyle. With growing technologies people have made a lot of behavioral changes. The pandemic reportedly increased behavioral health needs and impacted treatment access.

The differential changes during the COVID-19 pandemic in incident prescription trends for ADHD, particularly for C-II stimulants, underscore the need for robust policies to address unmet needs while balancing public health concerns says a new study in JAMA Pschiatry.

To assess changes in incident prescriptions dispensed for medications commonly used to treat depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and opioid use disorder (OUD), before and during the COVID-19 pandemic.

This was a cross-sectional study using comprehensive, population-level, nationally projected data from IQVIA National Prescription Audit on incident prescriptions (prescriptions dispensed to patients with no prior dispensing from the same drug class in the previous 12 months) dispensed for antidepressants, benzodiazepines, Schedule II (C-II) stimulants, nonstimulant medications for ADHD, and buprenorphine-containing medication for OUD (MOUD), from US outpatient pharmacies. Data were analyzed from April 2018 to March 2022. Incident prescriptions by drug class (by prescriber specialty, patient age, and sex) and drug.

Interrupted time-series analysis to compare changes in trends in the monthly incident prescriptions dispensed by drug class and percentage changes in aggregate incident prescriptions dispensed between April 2018 and March 2022.

The key findings of the study are

• Incident prescriptions dispensed for the 5 drug classes changed from 51 500 321 before the COVID-19 pandemic to 54 000 169 during the pandemic. The largest unadjusted percentage increase in incident prescriptions by prescriber specialty was among nurse practitioners across all drug classes ranging from 7% (from 1 811 376 to 1 944 852; benzodiazepines) to 78% (from 157 578 to 280 925; buprenorphine MOUD).
• The patient age and sex, the largest increases were within C-II stimulants and nonstimulant ADHD drugs among patients aged 20 to 39 years (30% and 81% respectively) and female patients (25% and 59% respectively).
• Trends for C-II stimulants and nonstimulant ADHD drugs (slope change: 4007 prescriptions per month and 1120 prescriptions per month respectively) significantly changed during the pandemic, exceeding prepandemic trends after an initial drop at the onset of the pandemic (level changes: −50 044 prescriptions and −12 876 prescriptions respectively).
• Although buprenorphine MOUD dropped significantly (level change: −2915 prescriptions), trends did not significantly change for buprenorphine MOUD, antidepressants, or benzodiazepines.

Researchers concuded that "Incident use of many behavioral health medications remained relatively stable during the COVID-19 pandemic in the US, whereas ADHD medications, notably C-II stimulants, sharply increased. Additional research is needed to differentiate increases due to unmet need vs overprescribing, highlighting the need for further ADHD guideline development to define treatment appropriateness."

Reference:

Chai G, Xu J, Goyal S, et al. Trends in Incident Prescriptions for Behavioral Health Medications in the US, 2018-2022. JAMA Psychiatry. Published online January 10, 2024. doi:10.1001/jamapsychiatry.2023.5045.