Teen Use of Stimulants for ADHD on the Rise

Study Shows More Teens Are Getting Prescriptions to Treat Attention Deficit Hyperactivity Disorder

Medically Reviewed by Laura J. Martin, MD on September 28, 2011
From the WebMD Archives

Sept. 28, 2011 -- More teens are receiving prescription stimulants to treat symptoms of their attention deficit hyperactivity disorder (ADHD).

Close to 9% of children aged 4 to 17 years have received a diagnosis of ADHD. It's a behavioral disorder marked by impulsiveness, hyperactivity, and inattention.

Stimulants such as Adderall, Concerta, Dexedrine, and Ritalin are often the first line of therapy. Treatment also involves behavioral changes, such as keeping set schedules and routines.

Researchers tracked how many children and teens under age 19 were taking stimulants from 1996 to 2008.

Overall, 3.5% or an estimated 2.8 million children received a prescription for a stimulant medication to treat ADHD in 2008. By contrast, 2.9% of kids were taking stimulants in 1996. Stimulant use increased at an average yearly rate of 3.4% from 1996 to 2008.

This is markedly slower than the 17% growth rate seen from 1987 to 1996, the researchers report in the American Journal of Psychiatry.

There are several non-stimulant medications approved to treat ADHD in children and teens. "Stimulants remain the main treatment for ADHD," says researcher Benedetto Vitiello, MD, of the National Institute of Mental Health in Bethesda, Md.

Rates of Stimulant Use

The use of stimulants remains highest among children aged 6-12, but teens aged 13 to 18 may be catching up. They had the fastest growth rate for prescribed use of stimulants in the new study, 2.3% in 1996 to 4.9% in 2008.

Other key findings about stimulant use among children with ADHD from 1996 to 2008 include:

  • Prescription stimulant use among preschoolers remained very low at 0.1% from 2004 to 2008.
  • Boys continued to be three times more likely than girls to be prescribed a stimulant.
  • Stimulant use is still higher among white children than African-American or Hispanic children, but the gap may be narrowing.
  • Stimulant prescription rates were substantially lower in Western states compared to other U.S. regions.

Side Effects of ADHD Drugs

Stimulants do have side effects such as decreased appetite and sleeplessness. There are some studies showing that they may also have some heart-related side effects.

"One needs to be attentive to side effects, especially cardiac effects in a patient who has heart problems," Vitiello says. "They are being used more and more and this means that people are accepting their drawbacks and risks."

There have been reports of a rise in prescription drug abuse -- and stimulants typically place high on the list of drugs that may be abused.

"There is ongoing concern that these drugs may not be used properly, especially when they are prescribed to college students or children in their late adolescence who are more in charge of their care and may not be using the medications as prescribed," he says. The study did not look at these issues.

There is always that issue of stimulant misuse, says Marshall Teitelbaum, MD, a child, adolescent, and adult psychiatrist in private practice in Jupiter, Fla. The abuse may be a result of what happens to medications that are left unattended in medicine cabinets, he says.

"Stimulants are still the most effective and commonly used medications that we have to treat ADHD," he says. "If we didn't have stimulants for ADHD, we would not be treating the vast majority of patients to our best ability."

It makes sense that the rate of stimulant use is low among preschool-aged kids, he says. "The younger the child, the more careful you are with medications in general. There are kids who are younger than 5 with ADHD and we would rather try behavioral techniques first before turning to any medication."

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Benedetto Vitiello, MD, National Institute of Mental Health, Bethesda, Md.

Marshall Teitelbaum, MD, child, adolescent, and adult psychiatrist, Jupiter, Fla.

Zuvekas, S.H. Vitiello B. American Journal of Psychiatry.

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