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, Långström 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 6–45 years, alive and registered as residents in Sweden during any calendar year from 2006 to 2009 (N = 5 149 791) included 41 700 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, 22–45 years old; 2.41 for adolescents, 15–21 years 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 3 years and 11 months, 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.