Recent Trends in Stimulant Medication Use Among U.S. Children

Division of Services and Intervention Research, NIMH, 6001 Executive Blvd., Bethesda, MD 20892-9633, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 05/2006; 163(4):579-85. DOI: 10.1176/appi.ajp.163.4.579
Source: PubMed


Stimulant medications, such as methylphenidate and amphetamines, are commonly prescribed to treat attention deficit hyperactivity disorder. Stimulant use increased fourfold from 1987 (0.6%) to 1996 (2.4%) among subjects 18-year-old and younger in the U.S. The aim of this study was to determine whether pediatric use of stimulants continued to rise during the period 1997-2002.
The Medical Expenditure Panel Survey (MEPS) database for the years 1997-2001 was analyzed. The MEPS is a yearly survey of a nationally representative sample of civilian, noninstitutionalized U.S. households, conducted by the U.S. Agency for Health Care Research and Quality. Previously reported estimates from the 1996 MEPS and the 1987 National Medical Expenditure Survey, the predecessor to MEPS, were also replicated to compare recent trends to changes between 1987 and 1996.
The prevalence use of stimulants among subjects under 19 years of age was 2.7% (95% C.I. 2.3-3.1) in 1997 and 2.9% (95% C.I. 2.5-3.3) in 2002, with no statistically significant change during these 6 years. Likewise, when pooling data across years and comparing the rate in 1997-1998 (2.8%) with the rate in 2001-2002 (3.0%), no statistically significant changes emerged. Use was highest among 6-12 year olds (4.8% in 2002), as compared with 3.2% among 13-19 year olds and 0.3% among children under 6. An estimated 2.2 million (95% C.I. 1.9-2.6) children received stimulant medication in 2002 as compared to 2.0 million (95% C.I. 1.7-2.3) in 1997.
The steep increase in the utilization of stimulants among children 18 years and younger that occurred over the 1987-1996 period attenuated in the following years through 2002, and has remained stable among very young children.

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    • "Worldwide, 5% -12% of children are estimated to suffer from ADHD [5] [6], and estimates in North America range from 11% to 16% [7]-[9]. As of 2005, one in 20 to 25 North American children were prescribed some form of psychostimulant for the treatment of ADHD [10]. DL-amphetamine acts similarly to many drugs of abuse by competing with dopamine for a common binding site, the dopamine transporter (DAT), thereby allowing dopamine to accumulate in the synapse and extracellular space [11]. "
    Journal of Behavioral and Brain Science 08/2014; 4(08):375-383. DOI:10.4236/jbbs.2014.48036
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    • "An increase in the treated incidence rate of ADHD was also observed, from 44.67 per 100,000 to 81.20 per 100,000. These findings are in line with figures reported in the literature, which show an increase in the prevalence of ADHD treatment during the past decade in the UK [25], the Netherlands [28], and the USA [33], [34]. Only one previous study known to us has estimated the epidemiology for treated ADHD in Taiwan [29]. "
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    ABSTRACT: We used insurance claims of a nationally representative population-based cohort to assess the longitudinal treated prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents and adults. Participants were identified from among National Health Insurance enrollees in Taiwan from 1999 to 2005. We identified study subjects who had at least one service claim during these years with a principal diagnosis of ADHD. A total of 6,173 patients were recorded in the treated ADHD cohort during the 6-year study. There was a significant increase in the treated prevalence rate of ADHD during the study period, from 64.65 per 100,000 in 2000 to 145.40 per 100,000 in 2005 (p = .001). An increase in the treated incidence rate of ADHD, from 44.67 per 100,000 in 2000 to 81.20 per 100,000 in 2005, was also observed (p = .013). However, the treated prevalence of ADHD was still lower than that of the community data in Taiwan. The peak treated prevalence of ADHD was at age 7-12 years for both males and females, and the peak treated incidence of ADHD was at age 0-6 for females and age 7-12 for males. Overall, the treated incidence and prevalence rates dropped abruptly after age 13-18 (both p<.001) for males and females (p<.001 for both). Male vs. female ratios of treated prevalence and incidence were both above 1 before age 25-30 years, but below 1 thereafter. Although an increasing number of people with ADHD sought treatment during 1999-2005 in Taiwan, the treated prevalence of ADHD was still lower than that of the community data. The treated incidence and prevalence of ADHD fell dramatically after age 13-18. However, more women than men sought treatment in adulthood. There may be under-diagnosis and under-treatment of ADHD, especially among females and adults.
    PLoS ONE 04/2014; 9(4):e95014. DOI:10.1371/journal.pone.0095014 · 3.23 Impact Factor
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    • "ADHD is one of the most commonly encountered behavioral problems in childhood. Treatment of ADHD with stimulant drugs, such as methylphenidate (MP), has greatly increased in recent years [5], [6]. MP has been associated with growth deceleration, specifically during the first years of treatment [7], [8], [9], [10], [11], [12], [13], [14]. "
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    ABSTRACT: Growth hormone (GH) treatment has become a frequently applied growth promoting therapy in short children born small for gestational age (SGA). Children born SGA have a higher risk of developing attention deficit hyperactivity disorder (ADHD). Treatment of ADHD with methylphenidate (MP) has greatly increased in recent years, therefore more children are being treated with GH and MP simultaneously. Some studies have found an association between MP treatment and growth deceleration, but data are contradictory. To explore the effects of MP treatment on growth in GH-treated short SGA children Anthropometric measurements were performed in 78 GH-treated short SGA children (mean age 10.6 yr), 39 of whom were also treated with MP (SGA-GH/MP). The SGA-GH/MP group was compared to 39 SGA-GH treated subjects. They were matched for sex, age and height at start of GH, height SDS at start of MP treatment and target height SDS. Serum insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) levels were yearly determined. Growth, serum IGF-I and IGFBP-3 levels during the first three years of treatment were analyzed using repeated measures regression analysis. The SGA-GH/MP group had a lower height gain during the first 3 years than the SGA-GH subjects, only significant between 6 and 12 months of MP treatment. After 3 years of MP treatment, the height gain was 0.2 SDS (±0.1 SD) lower in the SGA-GH/MP group (P = 0.17). Adult height was not significantly different between the SGA-GH/MP and SGA-GH group (-1.9 SDS and -1.9 SDS respectively, P = 0.46). Moreover, during the first 3 years of MP treatment IGF-I and IGFBP-3 measurements were similar in both groups. MP has some negative effect on growth during the first years in short SGA children treated with GH, but adult height is not affected.
    PLoS ONE 12/2012; 7(12):e53164. DOI:10.1371/journal.pone.0053164 · 3.23 Impact Factor
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