McCarthy, Suzanne; (2009) Post-marketing evaluation of adhd drug treatment in children and young adults. Doctoral thesis (Ph.D.), University College London (United Kingdom).

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Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting 3-5% of children. In the UK, three drugs are licensed for its treatment; methylphenidate, dexamfetamine and atomoxetine. There is a lack of evidence on the prescribing of these to UK patients; however the common belief, particularly in the media, is that these drugs are over-prescribed. In addition, ADHD was once considered a condition of childhood alone; however increasing evidence suggests that the condition persists into adulthood in a significant number of patients. Again, there is little data on the use of these medications in older adolescents and young adults. Finally, in recent times, there has been much debate and concern over the safety of these drugs due to a number of spontaneous reports of sudden death in patients taking these medications. In light of these issues, this study had the following objectives; 1) to examine the utilisation of these drugs; 2) to examine prescribing of these medications to older patients; 3) to examine the safety of these medications, in particular the issue of sudden death. This was a pharmacoepidemiological study which mainly utilised data from the General Practice Research Database (GPRD), a computerised database of anonymised patient records from approximately 5% of the UK population. The study showed that 1) prevalence of prescribing of these drugs has increased significantly over the last decade, however the prevalence of prescribing is much lower than prescribing rates reported in other countries; 2) prevalence of prescribing of these drugs decreases dramatically in older patients; 3) no increase in the rate of death or sudden death in patients taking these drugs was detected when compared to mortality rates from the general population.

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