Studies Highlight Rapid Expansion of ADHD Drug Prescribing

Three new studies highlight a rapid expansion in the prescribing of psychiatric stimulants and ADHD drugs, with increases documented among US youth, in Ontario, Canada during the COVID-19 pandemic, and in Australia following the expansion of remote telehealth.

A new study published in the Journal of the American Academy of Child & Adolescent Psychiatry finds that psychiatric drug prescriptions are increasing for US youth between the ages of six to 24 years old, driven mainly by stimulants. The overall prevalence of psychiatric drug use in US youth between six to 24 years old increased from 5.3% in 2001–2004 to 8.3% in 2017–2020. Children, adolescents, and young adults all saw increases in the prevalence of psychiatric drug use. This increase was most significant in the young adult group where psychiatric drug use increased at each interval, growing from 4.6% in 2001–2004 to 11% in 2017–2020. The prevalence rate for adolescents increased from 6.6% to 8.2% while the rate for children increased from 4.2% to 6.1%. Stimulant prescription rates nearly doubled between 2001 and 2020. In the young adult group, 0.2% were taking psychiatric stimulants in 2001–2004 compared to 5.6% in 2017–2020.

Overall polypharmacy rates rose from 1.8% in 2001–2004 to 3.3% in 2017–2020. The polypharmacy rate for young adults saw the most drastic increase, going from 0.8% in 2001–2004 to 5% in 2017–2020. Of the participants taking psychiatric drugs, 26% were exposed to potentially major drug-drug interactions, largely driven by the combination of antidepressants and antipsychotics. The study noted limitations: psychiatric drug use was self-reported and not confirmed through clinical records, the reported potential drug-drug interactions were based solely on observed combinations with potential negative effects rather than confirmed adverse events, and the data came exclusively from US residents.

A new study published in the Canadian Medical Association Journal finds that new prescriptions for ADHD drugs surged during the COVID-19 pandemic in Ontario, Canada. The majority of new ADHD prescriptions were given to women. The authors used provincial health records and prescription dispensing data and examined data from 327,053 people who received a new stimulant prescription in Ontario between January 2016 and June 2024. In January 2016, the rate of new stimulant prescriptions in Ontario was 0.16 per 1,000 adults per month. During the pandemic, that rate rose substantially to 0.44 per 1,000 adults per month, representing a 175% increase compared to pre-COVID levels. The increase was not linear; during the early pandemic, new stimulant prescription rates decreased before rising sharply.

A third study found that ADHD drug prescriptions significantly increased after the expansion of remote telepsychiatry in Australia.