Trends in Pediatric Attention-Deficit Hyperactive Disorder Diagnoses and Prescription Utilization: 2016 to 2019
Abstract
OBJECTIVE: Attention-deficit hyperactive disorder (ADHD) is one of the most common psychiatric disorders among children, with estimated prevalence of 7% to 15% worldwide. The aim of this analysis was to update and summarize trends in diagnosis, demographics, and drug utilization of pediatric patients with ADHD. METHODS: We used the Agency for Health care Research and Quality Medical Expenditure Panel Survey (MEPS), a survey of US individuals, families, their medical providers, and employers, using datasets from 2016 to 2019. The data sources from the MEPS database included the full-year consolidated files, medical conditions files, prescribed-medicines files, and condition-event link files for each year. We summarized trends in the proportion of children, ages 17 years and younger, with a diagnosis of ADHD, demographic information and a prescription for medication known to treat ADHD. In addition, we further stratified ADHD medication use by stimulant/nonstimulant categories. RESULTS: There was a 1.6% and 4.7% absolute increase in children with an ADHD diagnosis and those prescribed ADHD medications, respectively, from 2016 to 2019. Most of these children were male, non-Hispanic, and on public insurance. Of the children prescribed an ADHD medication and concomitant behavioral medications, stimulants-only use was the highest (60%-67%), followed by stimulants/nonstimulants (13%-15%), stimulant/antidepressants (6%-9%), and nonstimulants only (5%-9%). The proportion of patients with ADHD in the high-income and near-poor categories increased by 4% from 2016 to 2019. CONCLUSION: Diagnosis of ADHD among children is trending upward in the United States. Central nervous system stimulants, especially methylphenidate formulations, are the most prescribed ADHD medications for children 17 years and younger.
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Guanfacine improves prefrontal cortical connectivity by strengthening noradrenergic tone and postsynaptic receptor signaling, thereby enhancing working memory and impulse control.
“Guanfacine, an α2A-adrenergic receptor agonist, improves prefrontal cortical connectivity by strengthening noradrenergic tone and postsynaptic receptor signaling, thereby enhancing working memory and impulse control [154,155].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [154]
Atomoxetine enhances norepinephrine transmission in prefrontal circuits regulating attention and inhibition.
“Atomoxetine, a selective norepinephrine reuptake inhibitor (NRI), enhances NE transmission in prefrontal circuits regulating attention and inhibition [154,155].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [154]
Guanfacine improves attention and behavioral regulation in adults with emotional dysregulation.
“while guanfacine improves attention and behavioral regulation in adults with emotional dysregulation [154,155].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [154]
None of the nonstimulants are associated with abuse potential.
“Importantly, none are associated with abuse potential—an advantage that facilitates use in populations at risk for substance misuse [154,157].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [154]
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ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives
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“Atomoxetine, a selective norepinephrine reuptake inhibitor (NRI), enhances NE transmission in prefrontal circuits regulating attention and inhibition [154,155].”
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- Authors
- Kazarov, C., Peasah, S. K., McConnell, E., Fischer, K. K., & Good, C. B.
- Affiliations
- University of Pittsburgh (US)
- UPMC Health System (US)
- Corresponding author
- Kazarov, Christina
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2024-06-21
- Volume
- 45
- Issue
- 5
- Pages
- e397-e405
- ISSN
- 0196-206X (ISSN-L)
- 1536-7312
- OpenAlex
- W4399885782
- Cited by
- 4
- References
- 26
- Citations by year
- 2026: 3 · 2025: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, children with ADHD, stimulant medication, methylphenidate, non-stimulant medication, antidepressants, public insurance, income inequality
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Drug Utilization, Female, Humans, Infant, Male, Drug Prescriptions, United States
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