Trend reversal in ADHD therapy?

Turnaround in the prescription of ADHD drugs

29/04/2011

Barmer GEK reports a turnaround in the treatment of attention deficit hyperactivity disorders (ADHD). While the prescription of medicines for the treatment of ADHD has risen massively since the 1990s, there has been only a slight increase, sometimes even a decrease, in prescriptions in recent years.

The prescriptions for ADHD medication for the first time dropped slightly by around one percent in 2009, according to Barmer GEK's announcement on Thursday. Although the prescription rate of medicines remains at a high level, there is a trend reversal. For the head of the medical competence center of BARMER GEK, Dr. med. Ursula Marschall, this is also the result of the changed prescription requirements. „Where a variety of therapy methods are used and the parents are specifically supported, the use of medicines can also be reduced“; stressed marshal.

Prescription of ADHD drugs declines for the first time
The evaluation of the insurance data of the former Barmer Krankenversicherung (today: Barmer GEK) from the years 2004 to 2009 showed that the rates of increase in the prescription of ADHD drugs in the investigation period were always lower and in 2009 for the first time a decrease was recorded. However, the percentage growth was often double-digit in the past and prescribing ADHD drugs has almost doubled in the six years studied, from 33 to 64 million daily doses, as measured by daily doses. According to the Barmer GEK, prescribing medication for ADHD treatment in 2005 increased by 43.4 percent over the previous year, in 2006 by 20.7 percent; 2007 still by 10.8 percent and in 2008 by only 2.4 percent. In 2009, a slight decline of 1.2 percent was reported for the first time. For the Barmer GEK clear sign of a turnaround in the treatment of ADHD. Dr. Ursula Marschall attributes the first-time reduction in the use of drugs to changed prescriptive prescriptions, because today would „Ritalin & Co only administered if other therapies have not been used previously“.

Especially in children less ADHD drugs are prescribed
The turnaround in the treatment of ADHD can be seen especially in the children, report the experts of Barmer GEK. For example, in 2009, a reduction in the prescription of Ritalin & Co. by minus 8.5 percent was noted for children under the age of four, and for the five to nine-year-olds the decline was minus 5.4 percent in 2009. A very positive development, as confirmed by the experts of Barmer GEK. In contrast to the general trend, however, an increase in the prescriptions of ADHD drugs in the 20 to 29-year-olds by five percent in the year 2009. The preparations are, according to Dr. Marshal has not been approved for adult treatment. In order to remedy this legal gray area, the Federal Institute for Drugs and Medical Devices (BfArM) has also approved the prescription of the active substance methylphenidate for adults since April. „However, the approval extension only applies to a single preparation that will be available in the summer“, explained Dr. marshal.

Turnaround or statistical normality?
ADHD usually occurs in childhood and is characterized by attention problems, impulsivity often accompanied by hyperactivity. Experts estimate that around three to ten percent of all children in Germany suffer from ADHD symptoms. The disease, also known as Zappel-Philipp syndrome, has been diagnosed more and more frequently in recent decades and, accordingly, the use of medication for treatment has increased. That now for the first time a decline in the prescription of ADHD drugs was observed, could therefore be at least partly due to the fact that the number of people affected was also declining. However, this aspect is not taken into account in the evaluation of Barmer GEK and it also goes unmentioned that a decrease in the rates of increase with an overall increase in the level does not necessarily indicate a turnaround. In general, further increases - with the already high level of 64 million prescribed daily doses already achieved - will in the future only account for small percentage increases. (Fp)

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ADHD genetically conditioned?
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ADHD: Prescription of Ritalin is restricted

Image: Dieter Schütz