Medication Use Rising for Adults With Attention Disorder

[Skyler]

Report Says Medication Use Is Rising for Adults With Attention Disorder http://www.nytimes.com/2014/03/12/us/report-says-medication-use-is-rising-for-adults-with-attention-disorder.html?hp&_r=0

[Altostrata]

Here's the Express Scripts report http://lab.express-scripts.com/prescription-drug-trends/turning-attention-adhd/

 

The ADHD drugs not only increase productivity in work and at school, they are appetite suppressants. What's not to love?
 

REPORT: Turning Attention to ADHD

03.12.14 David Muzina, MD

Today we released the report, Turning Attention to ADHD: U.S. Medication Trends for Attention Deficit Hyperactivity Disorder, the most current and comprehensive analysis of ADHD medication use. According to our pharmacy claims data, between 2008 and 2012, the number of Americans who use medication to treat ADHD rose 36%, totaling more than 4.8 million privately insured individuals in 2012.

Most surprisingly, we saw the greatest increase in use during the five-year study period was among adults, with the largest gains seen in women ages 26 to 34, climbing 85%.

No Longer Just a Childhood Condition

While children are still the primary users of ADHD medications, the number of adults on these medications has been increasing at a much faster pace, up 53.4% vs. 18.9% from 2008 to 2012.

Among adults, women far outnumber men in their use of ADHD treatments, the reverse of childhood trends where only half as many girls as boys take ADHD medications. The number of males using ADHD drugs plummets after age 18, while women ages 19 to 25 surpass younger girls’ use of these medications, 4.4% vs. 3.5% respectively in 2012.

Other notable trends include:

• The percentage of boys ages 12 to 18 using ADHD medications reached 9% in 2012, an 18% increase from 2008.
• The southern region of the U.S. has the highest concentration of ADHD medication use, with South Carolina showing the greatest prevalence overall: 14% of 12 to 18 year olds are on an ADHD medication treatment.
• The prescribing of antipsychotic treatments is exceptionally high among those treated for ADHD (12% vs. 4% of non-ADHD medication users); however, the number has been declining in recent years.

[Note: My guess is this last is the prescription of Seroquel for ADHD drug-related sleep issues. -- Alto]

What’s Driving This Dramatic Shift?

The rapid increase in adult use of these medications is striking, especially because there is little research on how these treatments affect an older population.

Since females tend to present the inattentive form of ADHD and do not display disruptive behavior in school, their symptoms may be overlooked in childhood. As they age, they may become more aware of their symptoms and consult their physician.

There are, however, concerns that less appropriate uses of the medication may be behind the increase in use among women. Stimulant medications are known to decrease a person’s appetite and are sometimes used as a weight-loss aid. Also, some women may turn to these medications, or experience symptoms of attention disorders, as a result of keeping up with the multiple demands on their time.

While generally safe for the majority of the population of patients, stimulants prescribed for ADHD come with several serious safety concerns and have an addictive nature. Use of these medications can be dangerous for patients with heart problems and may cause serious interactions with other medications and conditions, like bipolar disorder.

The trends here signal a need to look more closely at how and why physicians prescribe these medications for adults and the need for prescribers to fully assess the entire psychosocial landscape of an individual patient prior to reaching for the prescription pad.

 

....
About the Report

From an annual sample size of approximately 15 million privately insured individuals under age 65, the research examined the de-identified pharmacy claims of more than 400,000 individuals who filled at least one prescription for a medication indicated for the treatment of ADHD during the five-year study period. The analysis includes trends in utilization, cost and the use of concurrent treatments including antidepressants, antipsychotics and behavioral therapy.

[Barbarannamated]

I would bet that many are on SS/NRIs first and then stimulants added on to treat Amotivational or apathy syndrome that develops after years of serotonergics.

[btdt]

Agree with Barb 

[Barbarannamated]

I would bet that many are on SS/NRIs first and then stimulants added on to treat Amotivational or apathy syndrome that develops after years of serotonergics.

Add neuroleptics / antipsychotics to my statement.

 

From article:

 

"The analysis includes trends in utilization, cost and the use of concurrent treatments including antidepressants, antipsychotics and behavioral therapy."

[Skyler]

Utterly depraved. I could write more, but I think that pretty much encapsulates what is going on.

[Jemima]

Aside from agreeing with Barb, could it possibly be that women in the 26-34 age group have too much to attend, like having a husband, kids, a career, and possibly aging parents to manage? Perhaps women in this age group who appear inattentive are stunned by their overwhelming responsibilities instead? Sheesh, this is sickening, literally and figuratively.

[Meimeiquest]

I loved Adderall. I could use some right now. Followed by Zyprexa and oxazepam to ensure a great night's sleep. Me and Elvis.

[btdt]

Will not start on this cause if I do I will never stop... and drive my peace into the ground nope not worth it tho I am so very tempted.  There are so many sides to this sword and it would just take way too much to cover it all properly.

[Meimeiquest]

I wouldn't really do it . Aug. 2012 I ground them all into pink powder.

[btdt]

I knew you were joking  

[Barbarannamated]

Do any reports show the "cocktails" or concurrent / previous meds used? It may be bias from my own experience, but I don't think too many doctors use ADD meds (no H in the inattentive type) as first line agents because they are Schedule II, highly controlled.

[Skyler]

Heh... they probably use it more if they think the patient does not want the medication. Not for those who do! (even when there are valid issues that would make this med helpful.)

[btdt]

Do any reports show the "cocktails" or concurrent / previous meds used? It may be bias from my own experience, but I don't think too many doctors use ADD meds (no H in the inattentive type) as first line agents because they are Schedule II, highly controlled.

What are types of drugs are schedule 2 what are the names of some you think may be used?

[btdt]

I looked it up. 

I know of two kids in the last few years both male both between 7-9 years old given these drugs as first line.

 

• Methylphenidate (Ritalin), Methylphenidate HCL (Concerta), and Dexmethylphenidate (Focalin): treatment of ADHD, narcolepsy, postural orthostatic tachycardia syndrome
•  one was followed up by an antidepressant and then an anti psychotic
•  
• the other stopped after severe adverse reaction
• so yes schedule 2 drugs are used here as the first thing they do 

[btdt]

I have read reports of students taking Adderal a to study there was one case that hit the new here last year of a young adult being addicted and getting the drug easily during exams from a doctor he killed himself and his parents went nuts in the media.  He was find when he left home to go to university and then he was dead. 

[btdt]

Do any reports show the "cocktails" or concurrent / previous meds used? It may be bias from my own experience, but I don't think too many doctors use ADD meds (no H in the inattentive type) as first line agents because they are Schedule II, highly controlled.

One story where it was used first line it was over there I guess... in your country.... our news is so mixed together I think it is mind country sometimes...

here is the link if you want to read it

http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?_r=0

[Barbarannamated]

I agree that kids are given ADHD drugs first line very often. I have several friends whose kids are on various Schedule II drugs. ADHD seems to be a more accepted or common diagnosis in kids and teens, especially boys, probably because teachers and parents complain about rambunctious behavior and/or lack of attention to schoolwork. Someone here on forum recently received a letter from their kid's school recommending ADHD treatment. I can't recall who that was, but I don't think it's uncommon for teachers to request treatment if kid is disruptive. Disgusting.

 

My HUNCH is that, in adults, it is more of a secondary diagnosis because most adults have learned not to act out and misbehave. Adults who act out or get in trouble are more likely to be labeled/treated as bipolar or some other diagnosis.

[Meimeiquest]

I have read reports of students taking Adderal a to study there was one case that hit the new here last year of a young adult being addicted and getting the drug easily during exams from a doctor he killed himself and his parents went nuts in the media.  He was find when he left home to go to university and then he was dead.

 

My nephew is a freshman at West Point. "Everyone" is using them, which in turns makes the playing field less level, and more pressure to do it.

[btdt]

Sure is a new kind of peer pressure drug use... when I was in school it was booze and pot. Now it's uppers what a strange world we live in.