Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries
Purpose The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries. Methods We conducted a multin...
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| Veröffentlicht in: | European journal of clinical pharmacology 2016-12, Vol.72 (12), p.1507-1514 |
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| container_title | European journal of clinical pharmacology |
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| creator | Karlstad, Øystein Zoëga, Helga Furu, Kari Bahmanyar, Shahram Martikainen, Jaana E Kieler, Helle Pottegård, Anton |
| description | Purpose
The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries.
Methods
We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18–64 years during 2008–2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants.
Results
Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men.
Conclusions
Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed. |
| doi_str_mv | 10.1007/s00228-016-2125-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_502697</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1841138354</sourcerecordid><originalsourceid>FETCH-LOGICAL-c558t-8904d112c82b242556a18d592d6931e86d897b875d81cef83b7f2abc2420d9153</originalsourceid><addsrcrecordid>eNp1ksFu1DAQhi0EosvCA3BBlrhwSZmx48S-IFUtUKQKLvRsObGzdUnixU5Ae-MheEKeBK82LS1STx55vn_GM_4JeYlwjAD12wTAmCwAq4IhE8XuEVlhyVmBUOJjsgLgWFSqhiPyLKVrABQK-FNyxGohK67UivSXydHQURvnTaJdiPTk7PyMmiGMG2rs3E_pz6_fhg458qOZfBhNT9M0290CoTiWdPB9n1OLgvqRTleOfg7R-pa2YR6n6F16Tp50pk_uxXKuyeWH919Pz4uLLx8_nZ5cFK0QciqkgtIislayhpVMiMqgtEIxWymOTlZWqrqRtbASW9dJ3tQdM02bWbAKBV-T4lA3_XTbudHb6AcTdzoYr5erbzlyWgDL68m8epDfxmD_iW6EyMtK1GVe8Jq8O2gzMDjbujyq6e-XuJcZ_ZXehB9aIEIN--ZvlgIxfJ9dmvTgU-v63owuzEmjLBG55KLM6Ov_0Oswx_whe4orUdUSq0zhgWpjSCm67vYxCHrvG33wjc6-0Xvf6F3WvLo7xa3ixigZYMuKcmrcuHin9YNV_wL1ptAj</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1839567816</pqid></control><display><type>article</type><title>Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries</title><source>MEDLINE</source><source>SWEPUB Freely available online</source><source>SpringerLink Journals - AutoHoldings</source><creator>Karlstad, Øystein ; Zoëga, Helga ; Furu, Kari ; Bahmanyar, Shahram ; Martikainen, Jaana E ; Kieler, Helle ; Pottegård, Anton</creator><creatorcontrib>Karlstad, Øystein ; Zoëga, Helga ; Furu, Kari ; Bahmanyar, Shahram ; Martikainen, Jaana E ; Kieler, Helle ; Pottegård, Anton</creatorcontrib><description>Purpose
The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries.
Methods
We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18–64 years during 2008–2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants.
Results
Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men.
Conclusions
Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed.</description><identifier>ISSN: 0031-6970</identifier><identifier>ISSN: 1432-1041</identifier><identifier>EISSN: 1432-1041</identifier><identifier>DOI: 10.1007/s00228-016-2125-y</identifier><identifier>PMID: 27586399</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adrenergic Uptake Inhibitors - therapeutic use ; Adult ; Adults ; Amphetamine - therapeutic use ; Atomoxetine Hydrochloride - therapeutic use ; Attention Deficit Disorder with Hyperactivity - drug therapy ; Attention Deficit Hyperactivity Disorder ; Biomedical and Life Sciences ; Biomedicine ; Central Nervous System Stimulants - therapeutic use ; Databases, Factual ; Dextroamphetamine - therapeutic use ; Drug use ; Drug Utilization - trends ; Female ; Humans ; Male ; Medicin och hälsovetenskap ; Methylphenidate - therapeutic use ; Middle Aged ; Pharmacoepidemiology and Prescription ; Pharmacology/Toxicology ; Psychotropic drugs ; Psychotropic Drugs - therapeutic use ; Scandinavian and Nordic Countries ; Stimulants ; Young Adult</subject><ispartof>European journal of clinical pharmacology, 2016-12, Vol.72 (12), p.1507-1514</ispartof><rights>The Author(s) 2016</rights><rights>European Journal of Clinical Pharmacology is a copyright of Springer, 2016.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-8904d112c82b242556a18d592d6931e86d897b875d81cef83b7f2abc2420d9153</citedby><cites>FETCH-LOGICAL-c558t-8904d112c82b242556a18d592d6931e86d897b875d81cef83b7f2abc2420d9153</cites><orcidid>0000-0003-1204-787X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00228-016-2125-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00228-016-2125-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27586399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:134657400$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Karlstad, Øystein</creatorcontrib><creatorcontrib>Zoëga, Helga</creatorcontrib><creatorcontrib>Furu, Kari</creatorcontrib><creatorcontrib>Bahmanyar, Shahram</creatorcontrib><creatorcontrib>Martikainen, Jaana E</creatorcontrib><creatorcontrib>Kieler, Helle</creatorcontrib><creatorcontrib>Pottegård, Anton</creatorcontrib><title>Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries</title><title>European journal of clinical pharmacology</title><addtitle>Eur J Clin Pharmacol</addtitle><addtitle>Eur J Clin Pharmacol</addtitle><description>Purpose
The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries.
Methods
We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18–64 years during 2008–2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants.
Results
Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men.
Conclusions
Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed.</description><subject>Adolescent</subject><subject>Adrenergic Uptake Inhibitors - therapeutic use</subject><subject>Adult</subject><subject>Adults</subject><subject>Amphetamine - therapeutic use</subject><subject>Atomoxetine Hydrochloride - therapeutic use</subject><subject>Attention Deficit Disorder with Hyperactivity - drug therapy</subject><subject>Attention Deficit Hyperactivity Disorder</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Central Nervous System Stimulants - therapeutic use</subject><subject>Databases, Factual</subject><subject>Dextroamphetamine - therapeutic use</subject><subject>Drug use</subject><subject>Drug Utilization - trends</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Methylphenidate - therapeutic use</subject><subject>Middle Aged</subject><subject>Pharmacoepidemiology and Prescription</subject><subject>Pharmacology/Toxicology</subject><subject>Psychotropic drugs</subject><subject>Psychotropic Drugs - therapeutic use</subject><subject>Scandinavian and Nordic Countries</subject><subject>Stimulants</subject><subject>Young Adult</subject><issn>0031-6970</issn><issn>1432-1041</issn><issn>1432-1041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>D8T</sourceid><recordid>eNp1ksFu1DAQhi0EosvCA3BBlrhwSZmx48S-IFUtUKQKLvRsObGzdUnixU5Ae-MheEKeBK82LS1STx55vn_GM_4JeYlwjAD12wTAmCwAq4IhE8XuEVlhyVmBUOJjsgLgWFSqhiPyLKVrABQK-FNyxGohK67UivSXydHQURvnTaJdiPTk7PyMmiGMG2rs3E_pz6_fhg458qOZfBhNT9M0290CoTiWdPB9n1OLgvqRTleOfg7R-pa2YR6n6F16Tp50pk_uxXKuyeWH919Pz4uLLx8_nZ5cFK0QciqkgtIislayhpVMiMqgtEIxWymOTlZWqrqRtbASW9dJ3tQdM02bWbAKBV-T4lA3_XTbudHb6AcTdzoYr5erbzlyWgDL68m8epDfxmD_iW6EyMtK1GVe8Jq8O2gzMDjbujyq6e-XuJcZ_ZXehB9aIEIN--ZvlgIxfJ9dmvTgU-v63owuzEmjLBG55KLM6Ov_0Oswx_whe4orUdUSq0zhgWpjSCm67vYxCHrvG33wjc6-0Xvf6F3WvLo7xa3ixigZYMuKcmrcuHin9YNV_wL1ptAj</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Karlstad, Øystein</creator><creator>Zoëga, Helga</creator><creator>Furu, Kari</creator><creator>Bahmanyar, Shahram</creator><creator>Martikainen, Jaana E</creator><creator>Kieler, Helle</creator><creator>Pottegård, Anton</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0003-1204-787X</orcidid></search><sort><creationdate>20161201</creationdate><title>Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries</title><author>Karlstad, Øystein ; Zoëga, Helga ; Furu, Kari ; Bahmanyar, Shahram ; Martikainen, Jaana E ; Kieler, Helle ; Pottegård, Anton</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-8904d112c82b242556a18d592d6931e86d897b875d81cef83b7f2abc2420d9153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adrenergic Uptake Inhibitors - therapeutic use</topic><topic>Adult</topic><topic>Adults</topic><topic>Amphetamine - therapeutic use</topic><topic>Atomoxetine Hydrochloride - therapeutic use</topic><topic>Attention Deficit Disorder with Hyperactivity - drug therapy</topic><topic>Attention Deficit Hyperactivity Disorder</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Central Nervous System Stimulants - therapeutic use</topic><topic>Databases, Factual</topic><topic>Dextroamphetamine - therapeutic use</topic><topic>Drug use</topic><topic>Drug Utilization - trends</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Methylphenidate - therapeutic use</topic><topic>Middle Aged</topic><topic>Pharmacoepidemiology and Prescription</topic><topic>Pharmacology/Toxicology</topic><topic>Psychotropic drugs</topic><topic>Psychotropic Drugs - therapeutic use</topic><topic>Scandinavian and Nordic Countries</topic><topic>Stimulants</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karlstad, Øystein</creatorcontrib><creatorcontrib>Zoëga, Helga</creatorcontrib><creatorcontrib>Furu, Kari</creatorcontrib><creatorcontrib>Bahmanyar, Shahram</creatorcontrib><creatorcontrib>Martikainen, Jaana E</creatorcontrib><creatorcontrib>Kieler, Helle</creatorcontrib><creatorcontrib>Pottegård, Anton</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>European journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karlstad, Øystein</au><au>Zoëga, Helga</au><au>Furu, Kari</au><au>Bahmanyar, Shahram</au><au>Martikainen, Jaana E</au><au>Kieler, Helle</au><au>Pottegård, Anton</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries</atitle><jtitle>European journal of clinical pharmacology</jtitle><stitle>Eur J Clin Pharmacol</stitle><addtitle>Eur J Clin Pharmacol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>72</volume><issue>12</issue><spage>1507</spage><epage>1514</epage><pages>1507-1514</pages><issn>0031-6970</issn><issn>1432-1041</issn><eissn>1432-1041</eissn><abstract>Purpose
The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries.
Methods
We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18–64 years during 2008–2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants.
Results
Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men.
Conclusions
Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27586399</pmid><doi>10.1007/s00228-016-2125-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1204-787X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-6970 |
| ispartof | European journal of clinical pharmacology, 2016-12, Vol.72 (12), p.1507-1514 |
| issn | 0031-6970 1432-1041 1432-1041 |
| language | eng |
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| source | MEDLINE; SWEPUB Freely available online; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adrenergic Uptake Inhibitors - therapeutic use Adult Adults Amphetamine - therapeutic use Atomoxetine Hydrochloride - therapeutic use Attention Deficit Disorder with Hyperactivity - drug therapy Attention Deficit Hyperactivity Disorder Biomedical and Life Sciences Biomedicine Central Nervous System Stimulants - therapeutic use Databases, Factual Dextroamphetamine - therapeutic use Drug use Drug Utilization - trends Female Humans Male Medicin och hälsovetenskap Methylphenidate - therapeutic use Middle Aged Pharmacoepidemiology and Prescription Pharmacology/Toxicology Psychotropic drugs Psychotropic Drugs - therapeutic use Scandinavian and Nordic Countries Stimulants Young Adult |
| title | Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries |
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