Pharmacoepidemiology of antipsychotic use in youth with ADHD: Trends and clinical implications

Michael L. Birnbaum, Ema Saito, Tobias Gerhard, Almut Winterstein, Mark Olfson, John M. Kane, Christoph U. Correll

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Although concern has been raised about antipsychotic prescribing to youth with attention-deficit/hyperactivity disorder (ADHD), the available database is limited to individual studies. Therefore, in order to provide a synthesis of prevalence and time trends, we conducted a systematic review and pooled analysis of pharmaco-epidemiologic data on antipsychotic use in ADHD youth. Of 1806 hits, 21 studies (N) were retained that reported analyzable data for three separate populations: 1) antipsychotic-treated youth (N = 15, n = 341,586); 2) ADHD youth (N = 9, n = 6,192,368), and 3) general population youth (N = 5, n = 14,284,916). Altogether, 30.5 ± 18.5 % of antipsychotic-treated youth had ADHD. In longitudinal studies, this percentage increased over time (1998-2007) from 21.7 ± 7.1 % to 27.7 ± 7.7 %, ratio = 1.3 ± 0.4. Furthermore, 11.5 ± 17.5 % of ADHD youth received antipsychotics. In longitudinal studies, this percentage also increased (1998-2006) from 5.5 ± 2.6 % to 11.4 ± 6.7 %, ratio = 2.1 ± 0.6. Finally, 0.12 ± 0.07 % of youth in the general population were diagnosed with ADHD and received antipsychotics. Again, in longitudinal studies, this percentage increased over time (1993-2007): 0.13 ± 0.09 % to 0.44 ± 0.49 %, ratio = 3.1 ± 2.2. Taken together, these data indicate that antipsychotics are used by a clinically relevant and increasing number of youth with ADHD. Reasons for and risk/benefit ratios of this practice with little evidence base require further investigation.

Original languageEnglish (US)
Article number382
JournalCurrent psychiatry reports
Volume15
Issue number8
DOIs
StatePublished - Aug 2013

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Keywords

  • ADHD
  • Antipsychotics
  • Attention-deficit/hyperactivity disorder
  • Correlates
  • Pharmacoepidemiology
  • Prescribing
  • Psychiatry
  • Trends

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