ADHD Prescriptions Spike in Young Women

Kayla Anderson, PhD, Centers for Disease Control

Kayla Anderson, PhD

According to new Centers for Disease Control (CDC) research, between 2003—2015, the number of privately insured US women aged 15–44 who filled a prescription to treat attention-deficit/hyperactivity disorder (ADHD) increased 344%.

Using the Truven Health MarketScan commercial database, researchers examined outpatient pharmacy prescription drug claims for ADHD medications among female patients which included 2.3­—6.8 million reproductive-age women per year who had ≥11 months of enrollment in a private health insurance that covered prescription drugs.

Researchers reported the percentage of women who filled at least 1 prescription for an ADHD medication rose from 0.9% in 2003 to 4% in 2015, a 344% increase.

“The substantial increase in the percentage of reproductive-aged women filling ADHD medication prescriptions from 2013 to 2015, across age groups and US geographic regions, is of public health concern given the high percentage of unintended pregnancies and uncertainty concerning the safety of ADHD medication exposure before and during pregnancy,” Kayla Anderson, PHD, Centers for Disease Control, writes in the Morbidity and Mortality Weekly Report.

Medication prescription increased for all included age groups and in all US geographic regions.

Overall, the largest increase occurred among women aged 25—29 with an increase of 700%, while the second largest was a 560% increase in women ages 30­–34.

The percentage of women prescribed the nonstimulant medication atomoxetine was stable over time (0% change from 2003—2015) however, the increase in the percentage of prescribed stimulants increased 388% from 2003 to 2015 with amphetamine salts (Adderall), lisdexamfetamine (Vyvanse) and methylphenidate (Ritalin) being the most commonly filled medications.

In 2015, the highest percentage of ADHD medication prescriptions filled were for those 15—19 years of age (5.4%), 20–34 (5.5%) and 25–29 (4%).

The highest percentage of ADHD medication prescriptions were filled by reproductive-aged women who resided in the South (4.8%) and North Central (4%) regions of the US, with the South seeing the largest increase from 2003—2015 (380%).

While physicians prescribing ADHD medications to reproductive-aged women is increasingly common, there is not much information available about the safety of taking ADHD medication during pregnancy.

“Given that half of US pregnancies are unintended, and early pregnancy is a critical period for fetal development, examining trends in ADHD medication prescriptions among reproductive-aged women is important to quantify the population at risk for potential exposure,” the researchers add.

Additional research is needed on ADHD medication safety during pregnancy to inform women and their health care providers about potential risks before and during pregnancy.

“Although evidence is limited and findings are mixed,” Anderson and colleagues write, “ADHD medication use during pregnancy might be linked to increased risk for poor pregnancy outcomes, including spontaneous abortion. The safety of ADHD medications with regard to risk for birth defects is largely unknown.”

Researchers found that ADHD prescription trends among young women in non-US populations align with the CDC’s findings that an increased percentage of women are filling ADHD medication prescriptions, with the highest percentage among younger reproductive-aged women.

The findings highlight the importance of necessary research to examine ADHD medication safety in the reproductive-aged women population before and during pregnancy.

The CDC’s initiative, Treating for Two: Safer Medication Use in Pregnancy helps to address the need, conducting research on medication safety before and during pregnancy allowing women and health care providers to make evidence-based decisions regarding the risks and benefits of treatment options for common conditions like ADHD.

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