Recent Trends in Medication Treatment for Attention-Deficit Hyperactivity Disorder.

Abstract

Objective: Attention-deficit hyperactivity disorder (ADHD) diagnosis rates and stimulant use have increased recently, particularly among adults, in the context of increased telehealth use and shortages in stimulant medications. To better understand changes in ADHD medication use and inform policy governing the prescribing of these medications, this study aimed to compare stimulant and nonstimulant fills for 2019 versus 2023.

Methods: This study used national all-payer prescription claims data for 2019 (before onset of the COVID-19 pandemic) and 2023 to calculate stimulant and nonstimulant ADHD medication fill rates overall and by patient age and prescriber specialty.

Results: Total ADHD medication fills increased 23.8%, from 72,849,441 in 2019 to 90,183,437 in 2023; stimulants accounted for most fills (91.4% in 2019; 88.9% in 2023). Whereas the number of stimulant fills rose 20.4% from 2019 to 2023, the number of nonstimulant fills increased at three times that rate (60.1%). Both stimulant and nonstimulant fills increased among adults, whereas stimulant fills decreased 6.5% among children (ages 0-18). Nurse practitioners and physician assistants were responsible for one in three ADHD prescription fills in 2023; nonstimulants were prescribed most commonly by these providers and by psychiatrists.

Conclusions: The number of ADHD medication fills rose substantially from 2019 to 2023. Although a majority of 2023 fills were stimulants, nonstimulant fills sharply increased, even though nonstimulants are not the first-choice ADHD medication treatment. This increase was likely due in part to stimulant shortages that continue to limit access to ADHD pharmacotherapy nationwide.