Prevalence of and change in the prescription of methylphenidate in Israel over a 2-year period.
BACKGROUND
The use of methylphenidate for the treatment of attention deficit-hyperactivity disorder (ADHD) has increased dramatically in the past decade in some countries in Europe and North America. In response to a public debate in Israel, several Knesset members introduced a legislative initiative that aims to limit the prescription of methylphenidate by physicians. The objective of this study was to examine the rate methylphenidate prescriptions dispensed for the treatment of ADHD in children in northern and central Israel in 1999 and 2001.


METHODS
The population included all children aged 0-18 years living in central or northern Israel and insured by the largest national health management organisation who were prescribed methylphenidate at least once in 1999 or 2001. This was a population-based prevalence study comparing the two timepoints using data from the health management organisation and descriptive statistics.


RESULTS
The overall 1-year prevalence of methylphenidate prescriptions dispensed to children was 1.01% in 1999 and 1.22% in 2001 (relative risk [RR] 1.21, 95% CI 1.15-1.26), an increase of 21%. Seventy-seven percent of those prescribed methylphenidate were boys. The prescription rate ranged from 0.2% (RR 1.24, 95% CI 0.76-2.05) in Arabic cities to 5.99% (RR 1.19, 95% CI 1.09-1.30) in kibbutzim; this wide variation by type of residence apparently involved cultural, racial and economic factors.


CONCLUSIONS
Israel shows no unusual or unexpected patterns in methylphenidate prescriptions dispensed to children and a lesser increase over time than other developed countries. This suggests that limiting physician freedom to prescribe methylphenidate to children may not be justified.
Fogelman
Yacov
Y
Department of Family Medicine, Leumit HMO and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. fogelman@netvision.net.il
Vinker
Shlomo
S
Guy
Nir
N
Kahan
Ernesto
E
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D015995:Prevalence
D000697:Central Nervous System Stimulants; D008774:Methylphenidate