Fewer Kids' Meds Prescribed - Except for ADHD

ADHD medication and contraception usage among kids has increased over past decade

(RxWiki News) Though the past decade has seen increases in prescription drugs used among adults, the use of doctor-prescribed medications among children has actually declined - with some exceptions.

From 2002 to 2010, adult prescriptions increased 22 percent, but most children's prescriptions declined and experienced significant shifts regarding what was prescribed.

While prescriptions for antibiotics and allergy medications decreased, prescriptions for attention deficit hyperactivity disorder (ADHD) medications and birth control shot up.

"Be sure your children take all prescribed medications."

Grace Chai, PharmD, a pharmacist in the Office of Surveillance and Epidemiology at the FDA's Center for Drug Evaluation and Research, and colleagues at the FDA wrote a paper describing changes in prescription drug use for US children from 2002 through 2010.

The researchers used two large prescription databases available to the FDA under contract to look at the patterns of prescriptions for children from birth up to age 17.

They found that seven percent fewer prescriptions overall were distributed to children in 2010 than in 2002, but prescription use of medication for ADHD and contraception has increased considerably.

Children are filling 46 percent more prescriptions for ADHD drugs and 93 percent more contraceptive prescriptions. They are also using 14 percent more asthma medications.

Among the medications getting prescribed less often from 2002 to 2010 are 14 percent fewer antibiotics, 61 percent fewer allergy medications, 14 percent fewer pain medications, 5 percent fewer depression medications and 42 percent fewer cold medicines that don't have an expectorant (a medication which helps clear mucus from the lungs) in them.

The authors speculated that the decrease in antibiotics may be attributed to success in helping parents understand that antibiotics are useless for viral infections and that developing antibiotic resistance can be a problem in the long run.

Still, the most common prescription for babies under 2 years old and children aged 2 to 11 was amoxicillin, a common antibiotic.

The most common prescription for teens, from age 12 to 17, was methylphenidate, which is marketed as Concerta or Ritalin and is prescribed for attention deficit hyperactivity disorder. Over 1.8 million children filled prescriptions for this drug in 2010.

The seven drugs classified as ADHD medications were tracked independently in the study, and the trends show that Ritalin/Concerta and Adderall (amphetamine/dextroamphetamine) remained fairly steady. Their use did decline slightly, along with a decline of a few other ADHD drugs, at the same time that Vyvanse (lisdexamfetamine dimesylate) became available in 2007 and its use began climbing.

The researchers said their data did not enable them to determine possible reasons behind the increase in ADHD medications. Approximately 17 million ADHD medications were dispensed in 2002, which rose to 25 million by 2010.

According to Glen Elliott, MD, PhD, a clinical professor at the Stanford University Department of Psychiatry and Behavioral Sciences, it's important to look beyond the numbers.

"Absolute numbers tell only part of the story," Dr. Elliott said. "If you count the total estimated prevalence of ADHD in children and adolescents, even with the increases in prescriptions, fewer than half are receiving medication."

Dr. Elliott, the chief psychiatrist and medical director at Children's Health Council, a non-profit mental health facility affiliated with Stanford University, said many of these children, however, may not "need" the medication.

Still, the studies revealing that there are far more ADHD diagnoses than prescriptions for the medications "argues against 'overprescribing' as the major cause in the change." He attributes the cause more likely to increased recognition of the condition for teens.

"Adolescents are a particular group with increased use of stimulants, and that reflects the widespread acknowledgement that it remains a serious disorder well past puberty," he said.

The study appeared online ahead of print June 18 in the journal Pediatrics. The research was funded by the US FDA. The authors indicated no financial conflicts of interest.

Review Date: 
June 25, 2012