Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults
Open accessAbstract
Background: Symptoms of attention-deficit hyperactivity disorder (ADHD) are known to persist into adulthood in the majority of cases. Aims: To determine the prevalence of methylphenidate, dexamfetamine and atomoxetine prescribing and treatment discontinuation in adolescents and young adults. Method: A descriptive cohort study using the UK General Practice Research Database included patients aged 15–21 years from 1999 to 2006 with a prescription for a study drug. Results: Prevalence of prescribing averaged across all ages increased 6.23-fold over the study period. Overall, prevalence decreased with age: in 2006, prevalence in males dropped 95% from 12.77 per 1000 in 15-year-olds to 0.64 per 1000 in 21-year-olds. A longitudinal analysis of a cohort of 44 patients aged 15 years in 1999 demonstrated that no patient received treatment after the age of 21 years. Conclusions: The prevalence of prescribing by general practitioners to patients with ADHD drops significantly from age 15 to age 21 years. The fall in prescribing is greater than the reported age-related decrease in symptoms, raising the possibility that treatment is prematurely discontinued in some young adults in whom symptoms persist.
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Many adults with ADHD were never diagnosed or treated for ADHD when they were children.
“Since the recognition of ADHD is relatively recent throughout much of Europe there are in addition many adults with ADHD who were never diagnosed or treated for ADHD when they were children [31].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [31]
Age-dependent change in presentation: hyperactivity and impulsivity become less obvious in adulthood, shifting to inner restlessness, inattention, disorganisation, and executive impairment; this may lead to discontinuation of treatment when still required.
“The more overtly impairing symptoms in childhood, hyperactivity and impulsivity, often become less obvious in adulthood, shifting the problem to more subtle symptoms such as inner restlessness, inattention, disorganisation and to impairment in behaviours related to executive functioning; and this may lead to discontinuation of treatment when they are still required [13,31,35-39].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [31]
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References 26 · Cited by 215
Research works printed but not linked: 2
- Rani F, Murray M, Byrne P, Wong IC. Epidemiology of antipsychotic prescribing to children and adolescents in UK primary care. Pediatrics 2008; 121: 1002-9.
- Wong ICK, Asherson P, Clifford S, Coghill D, DeSoysa R, Hollis C, et al. Cessation of attention deficit hyperactivity disorder drugs in the young (CADDY). Health Technol Assess (in press).
- Authors
- McCarthy, S., Asherson, P., Coghill, D., Hollis, C., Murray, M., Potts, L., Sayal, K., de Soysa, R., Taylor, E., Williams, T., & Wong, I. C. K.
- Affiliations
- University of London (GB)
- University of Dundee (GB)
- University of Nottingham (GB)
- Medicines and Healthcare products Regulatory Agency (GB)
- Corresponding author
- Wong, Ian C. K.
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-03
- Volume
- 194
- Issue
- 3
- Pages
- 273-277
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2145525277
- Cited by
- 215
- References
- 26
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 14 · 2023: 2 · 2022: 6 · 2021: 10 · 2020: 4 · 2019: 7 · 2018: 11 · 2017: 16 · 2016: 16 · 2015: 21 · 2014: 24 · 2013: 26 · 2012: 22
- FWCI
- 9.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (04/36/02)
- European Commission
- Health Technology Assessment Programme
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- attention deficit hyperactivity disorder, treatment discontinuation, adolescents, young adults, methylphenidate, d-amphetamine, atomoxetine, primary care prescribing
- MeSH terms
- Atomoxetine Hydrochloride, Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Cross-Sectional Studies, Dextroamphetamine, Female, United Kingdom, Humans, Male, Methylphenidate, Practice Patterns, Physicians', Propylamines, Cohort Studies, Prevalence, Dopamine Uptake Inhibitors, Withholding Treatment, Young Adult
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