Pharmacological Treatment of Children and Adolescents Diagnosed with Attention-deficit/hyperactivity Disorder at Mental Health Services in Qatar: A Retrospective Study

Abstract

This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD and identify the reasons of discontinuations of such medications. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. The consequences of ADHD could seriously impact the patient’s lives and thus parental training, behavioral therapies, and pharmacological interventions are main therapeutic options applied. This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD at CAMHS as a primary outcome measure. In addition to identifying the reasons of discontinuations of such medications (in terms of effectiveness, safety, and other reasons). The study also aimed to identify the incidence of psychotropic polypharmacy in such group and the incidence of co-existing diseases. Lastly, it aimed at investigating the adherence to the required monitoring parameters in this patient’s group. A Retrospective chart review for patients diagnosed with (ADHD) at Child and Adolescents’ Mental Health Services (CAMHS) in Qatar from Jan 2019 – Dec 2019 was conducted. Patients less than 18 years old, diagnosed with ADHD as per the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and who are on pharmacological treatment for ADHD were suitable to be included. Patients who are not on anti-ADHD medications were excluded from the study. Ninety-two patients were eligible to be included in the study. Autism Spectrum Disorder (ASD) were found to be the most coexisting condition in addition to ADHD in 16.3%. Methylphenidate was the most prescribed medication (68.5%) followed by Atomoxetine (30.4%). None of the participants were found on Modafinil, Guanfacine, Bupropion, or Benzodiazepines and none of them exceeded the maximum licensed dose of either Methylphenidate or Atomoxetine. Half (50%) of the sample on Atomoxetine discontinued treatment compared to 14.2% in methylphenidate group. The clinical practice of prescribing pharmacological options in ADHD was thoroughly in alignment with international guidelines. Long term use of these psychotropics in this particular group of patients on their neurobiological, behavioral and physical health should be studied further. None