The use of ADHD medications increased during the pandemic, research shows

The news

Prescriptions for medications used to treat attention deficit hyperactivity disorder have skyrocketed during the coronavirus pandemic, especially among women and patients ages 20 to 39. according to new research compiled by scientists at the US Food and Drug Administration.

The increase came as prescription rates remained relatively stable for other major classes of behavioral drugs used to treat conditions such as depression and anxiety, according to the study, which was published Wednesday in JAMA Psychiatry.

The reasons are not entirely clear, the researchers found, and could include pandemic-related stress, recognition of undiagnosed cases, over-prescribing and online marketing of drugs.

Lisa Cosgrove, a clinical psychologist at the University of Massachusetts, Boston, who was not involved in the study, said the results “seem counterintuitive” since the pandemic was a time when most people were not in school or the office , an environment where attention-related issues often come to light.

The study authors noted that social media may have played a role in the increase in ADHD prescriptions because telemedicine services “used social media services to advertise treatments for behavioral health problems, such as ADHD and eating disorders.”

Dr. Cosgrove, who studies psychiatric treatment practices, agreed. She hypothesized that online influencers and other people openly discussing their own ADHD diagnoses on platforms like TikTok might prompt viewers to explore and “self-diagnose.”

“There are so many TikTok videos about people who have been diagnosed with ADHD and are embracing the ADHD identity,” said Dr. Cosgrove.

Stephen Hinshaw, a professor of psychology at the University of California, Berkeley, and an expert on ADHD, said the “TikTok phenomenon” and other social media platforms have almost certainly led to overprescribing of medications, partly due to “quick and dirty” self-diagnosis via online questionnaires, along with easier access to online prescriptions for stimulants.

But one benefit, he said, is that social media has allowed many people to recognize that they had untreated ADHD. This may be especially true for women, he added, as they come to understand that ADHD isn’t just a “boy’s disease.” as it has long been characterized.

The numbers

The study, conducted by scientists at the Center for Drug Evaluation and Research, a division of the U.S. Food and Drug Administration, compared prepandemic drug prescriptions in five classes with prescriptions during the pandemic, which the study defined as a two-year period from April 2020 to March 2022. Compared to the previous two years, the pandemic period saw a decline in prescriptions for two classes of drugs: benzodiazepines, which are used to treat anxiety and other conditions, and buprenorphine, which is used to treat opiate use disorders . . The number of prescriptions for benzodiazepines decreased by 9 percent and the number of buprenorphine prescriptions decreased by 2 percent.

The number of prescriptions for antidepressants increased by 10 percent in that period. But the study authors note that the increases were consistent with similar patterns before the pandemic, so “the changes in levels and trends were not significant for antidepressants.”

In contrast, prescription rates for ADHD medications “have increased significantly during the Covid-19 pandemic and exceeded prepandemic rates, particularly among young adults and women,” the study found.

Among people ages 20 to 39, prescriptions for ADHD Schedule II stimulants, including Ritalin and Adderall, rose 30 percent. Schedule II drugs have a “high potential for abuse, which can lead to severe psychological or physical dependence.” according to the federal government. Prescriptions for non-stimulant ADHD medications rose by 81 percent among 20- to 39-year-olds and by 59 percent among women overall, the study found.

The research also revealed a shift in prescribers of the drugs. During the pandemic, prescriptions for ADHD stimulants by nurses rose 57 percent compared to that group’s prescriptions two years earlier, while prescriptions by psychiatrists fell 1 percent.

A similar pattern emerged with non-stimulant ADHD medications. Prescriptions by nurses rose 74 percent during the pandemic, compared to a 12 percent increase by psychiatrists.

Behind the numbers

The results raised several questions, the researchers wrote: In particular, to what extent were ADHD medications prescribed appropriately?

The sharp increase in prescriptions during the pandemic underscored the ongoing need “to define treatment appropriateness” and to examine “how marketing and prescribing practices evolved,” the authors concluded.

There is evidence that ADHD it was overdiagnosed even before the pandemic. Dr. Cosgrove also noted that the behavioral and mental health information was shared on TikTok and other platforms was often misleadingand she said there was a need for a more rigorous diagnosis.