By Nancy Walsh, Staff Writer, MedPage Today
Published: September 29, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
In 2008, these medications were used by 3.5% (95% CI 3.0 to 4.1) of children ages 18 and younger compared with 2.4% (95% CI 1.8 to 2.9) in 1996, according to Samuel H. Zuvekas, PhD, of the Agency for Healthcare Research and Quality in Rockville, Md., and Benedetto Vitiello, MD, of the National Institute of Mental Health in Bethesda, Md.
But among those ages 13 to 18, the rate of use increased by 6.5% annually, rising from 2.3% (95% CI 1.5 to 3.1) in 1996 and reaching 5% (95% CI 3.9 to 6.1) by 2008 (P<0.001), the researchers reported online in the American Journal of Psychiatry.
Some 9% of children ages 6 to 17 at some time have been diagnosed as having ADHD. Prescribing of stimulant medications rose sharply in the 1990s, and in the subsequent decade numerous new formulations were developed.
“As the market for ADHD medications has expanded, concerns have been raised about the possible misuse and abuse of stimulants, especially because the increase in ADHD diagnoses has been most marked in adolescents,” the researchers wrote.
To examine the patterns of use of drugs such as methylphenidate and amphetamines among young people, Zuvekas and Vitiello analyzed data from the Medical Expenditure Panel Survey, an ongoing report that follows trends in the treatment of psychiatric disorders.
They found that approximately 2.8 million children were using stimulants in 2008, a number that had risen by 3.4% each year since 1996.
The rate of use was highest among children ages 6 to 12, and that rate has held fairly steady over time — 4.2% (95% CI 3.2 to 5.2) were treated with stimulant medications in 1996, while 5.1% (95% CI 4.1 to 6.1) were on the drugs in 2008.
Children younger than 6 were the least common recipients of stimulant medications. Before 2004, yearly estimates for this age group were 0.3% to 0.4%, but thereafter fell to and remained at 0.1%, which was a significant decrease (t=3.71, P<0.001), according to the researchers.
Although a clinical trial in 2006 demonstrated efficacy for methylphenidate among preschool-age children, it also identified a higher incidence of adverse effects, and the current data showed that, in fact, ADHD medications are little used in the youngest children, Zuvekas and Vitiello pointed out.