The number of children aged 4 to 17 years being prescribed ADHD medications in the USA has been steadily rising since 1996, researchers from the NIH (National Institutes of Health) and AHRQ (Agency for Healthcare Research and Quality) have reported in the American Journal of Psychiatry. The authors wrote that attention deficit hyperactivity disorder, which often persists right into adulthood, is one of the most common disorders among children.

An individual with ADHD finds it hard to maintain concentration and pay attention and may have difficulties in controlling behavior and over-activity (hyperactivity). Stimulants, such as methylphenidate (Ritalin) or amphetamines (Adderall) are commonly used to treat ADHD. Cognitive behavioral therapy (CBT) as well as some other behavioral approaches have been shown to have some beneficial effects.

In 1987 only 0.6% of children were prescribed stimulant medications, compared to 2.7% in 1997. By 2002 the rate leveled at about 2.9%. However, the authors write that over the last couple of years the use of drugs and the number of diagnoses of ADHD has been rising again.

7.8% of children aged 4 to 17 years in 2003 were diagnosed with ADHD, compared to 9.5% in 2007, according to data gathered from the Health Resources and Services Administration’s National Survey of Children’s Health.

Co-author Benedetto Vitiello, M.D. said:

“Stimulant medications work well to control ADHD symptoms, but they are only one method of treatment for the condition. Experts estimate that about 60 percent of children with ADHD are treated with medication.”

Dr. Vitiello and Samuel Zuvekas Ph.D. gathered data from the Medical Expenditure Panel Survey, an AHRQ-sponsored nationally representative yearly survey of American homes, to find out how common stimulant prescribing was for individuals aged less than 19 years from 1996 to 2008.

Prescribing increased from 2.4% in 1996 to 3.5% in 2008 – what the authors described as a “slow but steady increase”; an average increase of 2.4% annually. From 1987 to 1996 the increase was approximately 17% per year.

Children aged six to twelve years had the highest overall rates of stimulant prescribing, which rose from 4.2% in 1996 to 5.1% in 2008. Among 13 to 18 year olds rates increased the fastest, from 2.3% in 1996 to 4.9% in 2008.

Dr. Vitiello said:

“This continuous increase among teens likely reflects a recent realization that ADHD often persists as children age. They do not always grow out of their symptoms.”

In 2004, only 0.1% of preschoolers received a stimulant prescription – in fact, for this age group rates dropped between 2002 and 2008.

Three times as many boys were prescribed ADHD medications than girls, the authors reported. Medication use among Caucasian children was 4.4% in 2008, compared to 2.9% for African-American kids and 2.1% among Hispanics.

Despite lower prescribing rates among ethnic minorities, stimulant use for this group of children is increasing. The authors believe this is because there is more recognition and acceptance of using medications for ADHD treatment in a wider spectrum of American society.

Western states have considerably lower ADHD prescription rates than in the rest of the USA – this area of the country has experienced no increase over the last few years. In the Northeast, however, rates went up from 2.7% in 2002 to 4.6% in 2008.

Dr. Zuvekas said:

“These persistent differences in prescribed stimulant use related to age, racial and ethnic background, and geographical location indicate substantial variability in how families and doctors approach ADHD treatment throughout the United States.”

When they compared the estimated ADHD rate among children with usage of prescribed medications, the authors found that a significant number are receiving no medications.

The authors wrote:

“The children with the most severe symptoms are more likely to be taking stimulants. Those with milder symptoms are more likely being treated with psychosocial treatments or other non-stimulant medications.”

Written by Christian Nordqvist