Average Duration of ADHD Medication Is 3 Years for Children, Adolescents
Investigators note that the long-term effects of attention deficit/hyperactivity disorder (ADHD) medication for children remain lacking.
In a new analysis from the University of Turku and the University of Helsinki in Finland, the average duration of attention deficit/hyperactivity disorder (ADHD) medication for children and adolescents is more than 3 years. However, investigators noted that the long-term effects in children have not been sufficiently studied, as the safety of ADHD medicine is only available for 1 year of follow-up.1
Investigators note that the long-term effects of attention deficit/hyperactivity disorder (ADHD) medication for children remain lacking. | Image Credit: Joel bubble ben - stock.adobe.com
“This is an important research opening, as the duration of long-term use of ADHD medication in children and adolescents in everyday life has only been studied to a very limited extent,” Päivi Ruokoniemi, MD, PhD, a specialist in both clinical pharmacology and therapeutics and child psychiatry from the University of Helsinki, said in a news release.1
ADHD is a long-term condition that often continues into adulthood and can include having a difficult time paying attention, being hyperactive, and being impulsive. Symptoms typically occur before age 12, and some children can have symptoms as early as 3 years of age, according to Mayo Clinic. ADHD affects more males than females, and symptoms can vary by sex.2
In the current study, investigators aimed to determine the treatment duration for children and adolescents starting ADHD medication between 2028 and 2019. Patients included children younger than 18 years who received reimbursement for ADHD medication. Children under 6 years and those with narcolepsy were excluded. Treatment was defined as the first reimbursed purchase for any ADHD medication.3
Investigators included 40,691 children and adolescents aged 6 to 18 years that purchased their first ADHD medication between January 1, 2008, and December 31, 2019. The median age was 9 years, and 77.4% were male. The median duration of medication was 3.2 years, and approximately one-fourth of patients discontinued treatment within 1 year. Further, another one-fourth continued treatment for at least 6.8 years, according to the study authors.3
Males tended to have longer treatment than females, and those who were younger when starting treatment often had longer durations of use. The longest duration was seen for males aged 6 to 8 years at a median of 6.3 years.1
“Our research shows that a significant proportion of young children, especially boys, are on ADHD medication for years, throughout their comprehensive school years,” Ruokoniemi said in the news release.1 “In this context, it is worrying that reliable research data on the safety of these medicines is only available for a follow-up period of up to one year. After all, we are talking about children at a very sensitive stage of development.”
The median follow-up time was approximately 3.8 years, and at the time of follow-up, 44.6% of patients were continuing treatment. Discontinuation was more common for older groups, with those aged 9 to 12 years approximately 2 times more likely to discontinue treatment than patients 6 to 8 years. Discontinuation was 3.6 times more likely in 13- to 15-year-olds and 3.9 times more likely in 16- to 18-year-olds compared to patients 6 to 8 years old.3
“The long-term effects of ADHD medicines have been studied extensively in various observational and uncontrolled research settings, but these are always prone to confounding and therefore do not provide reliable information on cause-and-effect relationships,” Ruokoniemi said in the news release.1 “Due to these uncertainties, it is important that ADHD medication is only started when non-pharmacological treatments have been deemed insufficient. Even in this case, it must be ensured that both the caregiver and the child, in accordance with the child’s age and level of development, have access to sufficient information on the expected benefits and harms of the medicine and the uncertainties associated with them.”
READ MORE: Mental and Behavioral Health Resource Center
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