Attention-Deficit/ Hyperactivity Disorder (ADHD) And Psychotropic Polypharmacy Trends In Children And Young Adults
Diagnoses of ADHD and usage of ADHD medications have increased in recent years among children and young adults. Concomitant psychotropic use in youth has also risen, despite a lack of safety and efficacy studies to support these trends. This study was designed to: (1) assess annual rates of ADHD medication prescribing and the frequency of psychotherapeutic polypharmacy among patients 2-24 years old with ADHD in the United States; (2) identify the most commonly prescribed ADHD medications and concomitantly prescribed psychotropics; and (3) assess if patient and provider characteristics are associated with an increased risk of ADHD or psychotropic polypharmacy. The dataset for the study was obtained from the National Ambulatory Medical Care Survey (NAMCS) for the period 2006-2015 and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases for the period 2006-2011. The study sample included visits of patients who were 2 to 24 years of age and prescribed one or more ADHD medications. The rate of ADHD medication prescribing in children and young adults has significantly increased from 2006 to 2015, along with an increasing prevalence of ADHD polypharmacy. Concomitant psychotropic polypharmacy has similarly increased, creating cause for concern with only limited data supporting safety and efficacy in these patients. Factors such as age, sex, payer source, year, and receipt of mental health services were significantly associated with ADHD or psychotropic polypharmacy. These trends in increased medication use and their association with specific visit-level characteristics emphasize the need to examine the impact of health care providers on ADHD decision making.