Monday, January 22, 2018

Uptick in Reproductive-Aged Women on ADHD Medications Raises Questions About Risks to Offspring


The percentage of privately insured U.S. women aged 15 to 44 who filled at least one prescription for attention-deficit/hyperactivity disorder (ADHD) medications increased 344% between 2003 and 2015, according to data recently released by the Centers for Disease Control and Prevention.

“The substantial increase in the percentage of reproductive-aged women filling ADHD medication prescriptions from 2003 to 2015, across age groups and U.S. geographic regions, is of public health concern given the high percentage of unintended pregnancies and uncertainty concerning the safety of ADHD medication exposure before and during pregnancy,” Kayla N. Anderson, Ph.D., and colleagues wrote.

Anderson and colleagues used the Truven Health MarketScan Commercial Database to examine outpatient pharmacy prescription drug claims for ADHD medications among women aged 15 to 44 years from 2003 to 2015. (The MarketScan data reflect health service use by people with private employer-sponsored insurance and their dependents in the United States.) Outpatient pharmacy claims for ADHD medications were identified using national drug codes, irrespective of the indication for use.

The final analysis included 2.3 to 6.8 million privately insured reproductive-aged women each year from 2003 to 2015. The percentage of women in the sample who filled a prescription for any ADHD medication increased from 0.9% in 2003 to 4.0% in 2015 (344%). The largest increase in ADHD prescriptions filled during this period occurred among women aged 25 to 29 years (700%).

“Among reproductive-aged women who filled any ADHD medication prescription in the given year, the percentage who filled a prescription for mixed amphetamine salts and lisdexamfetamine increased from 2003 to 2015, while the percentage who filled a prescription for methylphenidate and atomoxetine decreased over the same period,” the authors noted.

The authors acknowledged several limitations of the findings, including the fact the analysis was limited to only privately insured women with prescription drug coverage, who may or may not be prescribed ADHD medications at similar rates as those who are publicly insured. Nonetheless, they concluded, “The increasing trend toward prescribing ADHD medications to reproductive-aged women highlights the importance of research examining ADHD medication safety in this population, including safety before and during pregnancy.”

For related information, see the Psychiatric News article “Better Ways to Treat Child ADHD, New Thinking for Adults Needed.”

(Image: iStock/jacoblund)