Central stimulants in the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents. A naturalistic study of the prescription in Sweden, 1977-2007.

Janols L-O, Liliemark J, Klintberg K, Von Knorring A-L. Central stimulants in the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents. A naturalistic study of the prescription in Sweden, 1977-2007. Nord J Psychiatry 2009; 63: 508-516. Background: An increased prescription of central stimulants (CS) for treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents has been reported in Sweden. Aims: To follow-up the treatment with CS as concerns total as well as regional differences in prescription rate. Efficacy and side-effects reported and gender differences in prescription over time also have been summarized. Methods: Data from the Swedish Medical Products Agency (MPA) of individual licences, annual reports about patients on individual or clinic licences from the MPA and sales statistics from the National Pharmacy (Apoteket AB) have been used. Results: The number of new licences and prescriptions increased dramatically from 1992 to 2007 and a change of preparations was seen. Great differences (fivefold) between the 21 counties of Sweden were noticed. In the follow-up reports to the MPA, a good/moderate treatment effect was reported in 92% and adverse effects were reported in 4% leading to discontinuation of medication in 46% of them. Abuse/misuse of the preparation was suspected in 0.2% of the reports. A tendency of a reduction of the proportion of boys to girls treated through individual licences has been seen. Conclusions: The study, although observational, supports good efficacy, limited adverse effects and a low degree of misuse in clinical use of CS for children and adolescents with ADHD.