Prescriptions for medications used to treat attention deficit hyperactivity disorder have emerged during the coronavirus pandemic, particularly among women and patients aged 20 to 39, according to new research compiled by researchers affiliated with the United States Food and Drug Administration.
The increase came as prescription rates remained relatively stable for other key classes of behavioral health drugs used to treat conditions such as depression and anxiety, according to the study published Wednesday in JAMA Psychiatry.
The reasons are not entirely clear, the researchers found, and could include pandemic-related stress, recognition of undiagnosed cases, overprescribing 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 findings “seem counterintuitive” since the pandemic was a time when most people did not were not in school or the office, environments where attention-related issues often come to light.
The study authors noted that social media may have played a role in the increase in prescriptions for ADHD, as telemedicine services “used social media services to advertise treatments for ADHD problems.” behavioral health, such as ADHD and eating disorders.”
Dr. Cosgrove, who studies psychiatric treatment practices, agrees. She hypothesized that online influencers and others who spoke openly on platforms like TikTok about their own ADHD diagnoses might have inspired viewers to explore and “self-diagnose.”
“There are so many TikTok videos about people who have been diagnosed with ADHD and embracing the ADHD identity,” Dr. Cosgrove said.
Stephen Hinshaw, a psychology professor at the University of California, Berkeley and an ADHD expert, said the “TikTok phenomenon” and other social media platforms have almost certainly led to overprescription of medications in part because of ” quick, quick problems.” “dirty” self-diagnoses through online questionnaires, as well as easier access to online prescriptions for stimulants.
But one benefit, he added, is that social media may have allowed many people to recognize that they had untreated ADHD. This may be especially true for women, he added, as they understand that ADHD is not just a “boy’s disease,” as it has long been characterized.
The study, conducted by scientists at the Center for Drug Evaluation and Research, a division of the U.S. Food and Drug Administration, compared pre-pandemic prescriptions for drugs from 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 disorders, and buprenorphine, which is used to treat opioid use disorder. . Benzodiazepine prescriptions fell 9 percent and buprenorphine prescriptions fell 2 percent.
Prescriptions for antidepressants increased by 10 percent during this period. But the study authors note that the increases were consistent with similar trends before the pandemic, so “changes in levels and trends were not significant for antidepressants.”
In contrast, ADHD medication prescription rates “increased significantly during the Covid-19 pandemic, exceeding pre-pandemic rates, particularly among young adults and women,” according to the study.
Among people aged 20 to 39, prescriptions for ADHD type II stimulants, including Ritalin and Adderall, increased by 30 percent. Schedule II drugs “have a high potential for abuse that can lead to serious psychological or physical dependence.” according to the federal government. Prescriptions for nonstimulant ADHD medications increased 81 percent among 20- to 39-year-olds and 59 percent among women overall, according to the study.
The study also found a change in drug prescribers. During the pandemic, ADHD stimulant prescriptions by nurse practitioners increased 57 percent compared to that group’s prescriptions two years prior, while prescriptions by psychiatrists fell 1 percent.
A similar trend emerged with non-stimulant medications for ADHD. Prescriptions for nurse practitioners increased 74 percent during the pandemic, compared to a 12 percent increase for psychiatrists.
Behind the numbers
The findings raised several questions, the researchers write: including, to what extent were ADHD medications prescribed appropriately?
The surge in prescribing during the pandemic has highlighted the continued need to “define treatment adequacy,” as well as explore “how marketing and prescribing practices have evolved,” the authors conclude.
Some evidence suggests that ADHD was overdiagnosed even before the pandemic. Dr. Cosgrove also noted that behavioral and mental health information shared on TikTok and other platforms was often misleadingand she said a more rigorous diagnosis was needed.