Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults.
BACKGROUND
Symptoms of attention-deficit hyperactivity disorder (ADHD) are known to persist into adulthood in the majority of cases.


OBJECTIVE
To determine the prevalence of methylphenidate, dexamfetamine and atomoxetine prescribing and treatment discontinuation in adolescents and young adults.


METHODS
A descriptive cohort study using the UK General Practice Research Database included patients aged 15-21 years from 1999 to 2006 with a prescription for a study drug.


RESULTS
Prevalence of prescribing averaged across all ages increased 6.23-fold over the study period. Overall, prevalence decreased with age: in 2006, prevalence in males dropped 95% from 12.77 per 1000 in 15-year-olds to 0.64 per 1000 in 21-year-olds. A longitudinal analysis of a cohort of 44 patients aged 15 years in 1999 demonstrated that no patient received treatment after the age of 21 years.


CONCLUSIONS
The prevalence of prescribing by general practitioners to patients with ADHD drops significantly from age 15 to age 21 years. The fall in prescribing is greater than the reported age-related decrease in symptoms, raising the possibility that treatment is prematurely discontinued in some young adults in whom symptoms persist.
McCarthy
Suzanne
S
Centre for Paediatric Pharmacy Research, School of Pharmacy, University of London and Institute of Child Health, University College London, UK.
Asherson
Philip
P
Coghill
David
D
Hollis
Chris
C
Murray
Macey
M
Potts
Laura
L
Sayal
Kapil
K
de Soysa
Ruwan
R
Taylor
Eric
E
Williams
Tim
T
Wong
Ian C K
IC
D000293:Adolescent; D000328:Adult; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003913:Dextroamphetamine / Q000627:therapeutic use; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D011437:Propylamines / Q000627:therapeutic use; D006113:United Kingdom; D028761:Withholding Treatment / Q000639:trends*; D055815:Young Adult
D018765:Dopamine Uptake Inhibitors; D011437:Propylamines; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride; D003913:Dextroamphetamine