Current ADHD medications may not meet needs of adult patients

ATLANTA — Data presented here showed adults with attention-deficit/hyperactivity disorder were prescribed combination treatment with a long-acting monotherapy, suggesting that currently available medications may not meet patient needs.

To determine prescription patterns among adults with ADHD in the United States, researchers analyzed Truven Marketscan claims data for 206,443 adults with ADHD who received at least one treatment in 2013. Index treatment was defined by researchers as the first ADHD treatment episode of at least 30 days in 2013. Combination therapy was defined by researchers as concomitant use of two or more ADHD medications for at least 30 days and identified by an overlap of at least 30 days between index treatment and one or more different ADHD treatments. Study participants had a mean age of 32.9 years.

Overall, 56.9% of the cohort used long-acting monotherapy, 30.7% used short-acting monotherapy and 12.5% combined different ADHD medications. These included long-acting plus short-acting monotherapy (10.3%), long-acting plus long-acting monotherapy (1.3%), short-acting plus short-acting monotherapy (0.4%) or more than two treatments (0.5%).

The most common long-acting treatments were dextroamphetamine and amphetamine mixed salts (39.2%), lisdexamfetamine (31.5%) and methylphenidate (19.9%).

The most common short-acting treatments were dextroamphetamine and amphetamine mixed salts (81.7%) and methylphenidate (14.5%).

The most common combination therapies among participants who used long-acting plus long-acting monotherapy were branded and generic dextroamphetamine and amphetamine mixed salts (13.7%); lisdexamfetamine and generic dextroamphetamine and amphetamine mixed salts (10.8%); and lisdexamfetamine and guanfacine extended-release (10.7%).

The most common combination therapies among participants who used short-acting plus short-acting monotherapy were generic dextroamphetamine and amphetamine mixed salts and clonidine immediate-release (33.5%); generic dextroamphetamine and amphetamine mixed salts and generic methylphenidate (17.9%); and branded and generic dextroamphetamine and amphetamine mixed salts (11.1%).

Among participants who used long-acting plus short-acting monotherapy, the most common combinations were long-acting and short-acting generic dextroamphetamine and amphetamine mixed salts (39.2%); lisdexamfetamine and generic dextroamphetamine and amphetamine mixed salts (16.7%); and long-acting and short-acting generic methylphenidate (12.6%).

“During 2013, the majority of adults with ADHD in a commercially insured U.S. population were treated with a [long-acting] stimulant. Furthermore, some adults received a combination therapy with a [long-acting] agent, suggesting that currently marketed ADHD medications do not meet the needs of some patients,” the researchers wrote. “Future studies should examine unmet treatment needs among adults with ADHD.” – by Amanda Oldt

Reference:

Grebla R, et al. Medication use among commercially-insured adults with attention-deficit/hyperactivity disorder (ADHD) in the US. Presented at: American Psychiatric Association Annual Meeting; May 14-18, 2016; Atlanta.

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