TY - JOUR
T1 - Pharmacoepidemiology of antipsychotic use in youth with ADHD
T2 - Trends and clinical implications
AU - Birnbaum, Michael L.
AU - Saito, Ema
AU - Gerhard, Tobias
AU - Winterstein, Almut
AU - Olfson, Mark
AU - Kane, John M.
AU - Correll, Christoph U.
N1 - Funding Information:
Christoph U. Correll has been a consultant and/or advisor to or has received honoraria from Actelion, Alexza, American Academy of Child and Adolescent Psychiatry, Bristol-Myers Squibb, Cephalon, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Lundbeck, MedAvante, Medscape, Merck, NIMH, Janssen/J&J, Otsuka, Pfizer, ProPhase, Roche, Sunovion, Takeda, Teva, and Vanda. He has received grant support from BMS, Feinstein Institute for Medical Research, Janssen/Johnson & Johnson, NIMH, National Alliance for Research in Schizophrenia and Depression, and Otsuka. He has been a Data Safety Monitoring Board member for Cephalon, Eli Lilly, Janssen, Lundbeck, Pfizer, Takeda, and Teva.
Funding Information:
Acknowledgments Funding for this study was supported in part by The Zucker Hillside Hospital Mental Advanced Center for Intervention and Services Research for the Study of Schizophrenia (P30MH090590) from the National Institute of Mental Health (NIMH). The NIMH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
PY - 2013/8
Y1 - 2013/8
N2 - 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.
AB - 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.
KW - ADHD
KW - Antipsychotics
KW - Attention-deficit/hyperactivity disorder
KW - Correlates
KW - Pharmacoepidemiology
KW - Prescribing
KW - Psychiatry
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=84882400986&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84882400986&partnerID=8YFLogxK
U2 - 10.1007/s11920-013-0382-3
DO - 10.1007/s11920-013-0382-3
M3 - Article
C2 - 23881713
AN - SCOPUS:84882400986
VL - 15
JO - Current Psychiatry Reports
JF - Current Psychiatry Reports
SN - 1523-3812
IS - 8
M1 - 382
ER -