European Journal of Clinical Pharmacology

, Volume 68, Issue 10, pp 1443–1450 | Cite as

The use of medication against attention deficit hyperactivity disorder in Denmark: a drug use study from a national perspective

  • Anton Pottegård
  • Bine Kjøller Bjerregaard
  • Dorte Glintborg
  • Jesper Hallas
  • Søren Ilsøe Moreno
Pharmacoepidemiology and Prescription



The purpose of the study was to characterize the utilization of medication against attention deficit hyperactivity disorder (ADHD) in Denmark between 1995 and 2011 from a national perspective, by using population-based prescription data.


National data on drug use in Denmark between 1 January 1995 and 30 September 2011 were extracted from the Registry of Medicinal Product Statistics (RMPS). Drug utilization was characterized using descriptive statistics.


A total of 1,085,090 prescriptions issued to 54,020 persons were identified. The incidence rate was stable in the last 3 years of the study period, and a slightly decreasing incidence rate and a stabilizing prevalence were observed towards the end of this period. The therapeutic intensity was 6.7 defined daily dose/person/day, with large regional differences that ranged from 64 to 145 % of the national average. Methylphenidate accounted for 92.6 % of DDDs used. The general practitioner (GP) rarely initiated treatment, although treatment initiation based on the GP’s advice increased with older age of the patient. Maintenance treatment was found to be distributed roughly equally between prescriber types. For methylphenidate, 1 % of users accounted for 6.1 % of the drug volume and 50 % of users accounted for 84.4 %. The data therefore do not suggest a high proportion of heavy users.


The findings of this analysis are mostly reassuring, with the data indicating a seemingly stagnant incidence and prevalence rate and lacking evidence of heavy users. However, the prescriber profile for incident users and the large regional variances raise concerns. It is therefore vital that the use of ADHD drugs is closely monitored.


ADHD Drug utilization Denmark Psychostimulants Methylphenidate Atomoxetine 


  1. 1.
    Polanczyk G, Rohde LA (2007) Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Curr Opin Psychiatry 20(4):386–92PubMedCrossRefGoogle Scholar
  2. 2.
    Fayyad J, De GR, Kessler R, Alonso J, Angermeyer M, Demyttenaere K et al (2007) Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry 190:402–9PubMedCrossRefGoogle Scholar
  3. 3.
    Danish National Board of Health. [Guide to medicamental treatment of children and adolescents with psychiatric disorders] [https://www retsinformation dk/Forms/R0710 aspx?id = 114817]; Last updated: 12-10-2010].
  4. 4.
    Cooper WO, Habel LA, Sox CM, Chan KA, Arbogast PG, Cheetham TC (2011) et al. ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults, N Engl J MedGoogle Scholar
  5. 5.
    Smith G, Jongeling B, Hartman P (2010) RUssell C, Landou L. Long-term outcomes associated with stimulation medication in the treatment of ADHD in children. Government of Western Australia; Published in, Raine ADHD StudyGoogle Scholar
  6. 6.
    Gillberg C, Melander H, von Knorring AL, Janols LO, Thernlund G, Hagglof B et al (1997) Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, double-blind, placebo-controlled trial. Arch Gen Psychiatry 54(9):857–64PubMedCrossRefGoogle Scholar
  7. 7.
    Hoza B, Gerdes AC, Mrug S, Hinshaw SP, Bukowski WM, Gold JA et al (2005) Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol 34(1):74–86PubMedCrossRefGoogle Scholar
  8. 8.
    National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up (2004) 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder. Pediatrics 113(4):754–61CrossRefGoogle Scholar
  9. 9.
    Breggin PR (2001) MTA Study has flaws. Arch Gen Psychiatry 58(12):1184–7PubMedCrossRefGoogle Scholar
  10. 10.
    Wilens TE, Adler LA, Adams J, Sgambati S, Rotrosen J, Sawtelle R et al (2008) Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 47(1):21–31PubMedCrossRefGoogle Scholar
  11. 11.
    Kildemoes HW, Sorensen HT, Hallas J (2011) The Danish National Prescription Registry. Scand J Public Health 39(7 Suppl):38–41PubMedCrossRefGoogle Scholar
  12. 12.
    Hallas J, Stovring H (2006) Templates for analysis of individual-level prescription data. Basic Clin Pharmacol Toxicol 98(3):260–5PubMedCrossRefGoogle Scholar
  13. 13.
    Ohayon MM, Priest RG, Zulley J, Smirne S, Paiva T (2002) Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology 58(12):1826–33PubMedCrossRefGoogle Scholar
  14. 14.
    Zuvekas SH, Vitiello B, Norquist GS (2006) Recent trends in stimulant medication use among U.S. children. Am J Psychiatry 163(4):579–85PubMedCrossRefGoogle Scholar
  15. 15.
    Trip AM, Visser ST, Kalverdijk LJ, de Jong-van den Berg LT (2009) Large increase of the use of psycho-stimulants among youth in the Netherlands between 1996 and 2006. Br J Clin Pharmacol 67(4):466–8PubMedCrossRefGoogle Scholar
  16. 16.
    Schubert I, Koster I, Lehmkuhl G (2010) The changing prevalence of attention-deficit/hyperactivity disorder and methylphenidate prescriptions: a study of data from a random sample of insurees of the AOK Health Insurance Company in the German State of Hesse, 2000–2007. Dtsch Arztebl Int 107(36):615–21PubMedGoogle Scholar
  17. 17.
    Zoega H, Furu K, Halldorsson M, Thomsen PH, Sourander A, Martikainen JE (2011) Use of ADHD drugs in the Nordic countries: a population-based comparison study. Acta Psychiatr Scand 123(5):360–7PubMedCrossRefGoogle Scholar
  18. 18.
    Rosler M, Casas M, Konofal E, Buitelaar J (2010) Attention deficit hyperactivity disorder in adults. World J Biol Psychiatry 11(5):684–98PubMedCrossRefGoogle Scholar
  19. 19.
    Pedersen E. [ADHD among adults - a life in frustration and chaos]. Månedsskrift for Almen Praksis 2008;May 86(5):537.Google Scholar
  20. 20.
    Asheim H, Nilsen KB, Johansen K, Furu K (2007) Prescribing of stimulants for ADHD in Nordland County. Tidsskr Nor Laegeforen 127(18):2360–2PubMedGoogle Scholar
  21. 21.
    Zoega H, Baldursson G, Halldorsson M (2007) Use of methylphenidate among children in Iceland 1989-2006. Laeknabladid 93(12):825–32PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Anton Pottegård
    • 1
    • 2
    • 4
  • Bine Kjøller Bjerregaard
    • 3
  • Dorte Glintborg
    • 2
  • Jesper Hallas
    • 1
  • Søren Ilsøe Moreno
    • 2
  1. 1.Clinical Pharmacology, Institute of Public HealthUniversity of Southern DenmarkOdense CDenmark
  2. 2.Institute for Rational PharmacotherapyDanish Medicines AgencyKøbenhavn SDenmark
  3. 3.Medicines Control Division, Statistics and AnalysisDanish Medicines AgencyKøbenhavn SDenmark
  4. 4.Clinical PharmacologyUniversity of Southern DenmarkOdense CDenmark

Personalised recommendations