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

Zetterqvist J, Asherson P, Halldner L, Langstrom N, Larsson H. Stimulant and non-stimulant attention deficit/hyperactivity disorder drug use: total population study of trends and discontinuation patterns 2006-2009. 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 6-45years, alive and registered as residents in Sweden during any calendar year from 2006 to 2009 (N=5149791) included 41700 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, 22-45years old; 2.41 for adolescents, 15-21years 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 3years and 11months, 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.