Current Psychiatry Reports

, 15:382

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
Attention-Deficit Disorder (R Bussing, Section Editor)

DOI: 10.1007/s11920-013-0382-3

Cite this article as:
Birnbaum, M.L., Saito, E., Gerhard, T. et al. Curr Psychiatry Rep (2013) 15: 382. doi:10.1007/s11920-013-0382-3
Part of the following topical collections:
  1. Topical Collection on Attention-Deficit Disorder

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.

Keywords

Attention-deficit/hyperactivity disorderADHDAntipsychoticsPrescribingTrendsCorrelatesPharmacoepidemiologyPsychiatry

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael L. Birnbaum
    • 1
  • Ema Saito
    • 1
    • 2
  • Tobias Gerhard
    • 3
    • 4
  • Almut Winterstein
    • 5
  • Mark Olfson
    • 6
  • John M. Kane
    • 1
    • 2
    • 7
    • 8
  • Christoph U. Correll
    • 1
    • 2
    • 7
    • 8
  1. 1.Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore–Long Island Jewish Health SystemGlen OaksUSA
  2. 2.Hofstra North Shore LIJ School of MedicineHempsteadUSA
  3. 3.Department of Pharmacy Practice and Administration, Ernest Mario School of PharmacyRutgers UniversityPiscatawayUSA
  4. 4.Institute for Health, Health Care Policy and Aging ResearchRutgers UniversityNew BrunswickUSA
  5. 5.Department of Pharmaceutical Outcomes and Policy and Department of EpidemiologyUniversity of FloridaGainesvilleUSA
  6. 6.New York State Psychiatric Institute/Department of PsychiatryCollege of Physicians and Surgeons of Columbia UniversityNew YorkUSA
  7. 7.The Feinstein Institute for Medical ResearchManhassetUSA
  8. 8.Albert Einstein College of MedicineBronxUSA