Prescriptions for attention deficit hyperactivity disorder (ADHD) medications spiked during the COVID-19 pandemic, a new government report shows.
The trend may reflect both greater awareness among adults of ADHD symptoms and increased stress driving people to get the care they need.
â€śThis report shows there is this growing population of adults who have been diagnosed with ADHD, and there is need for support for this population,â€ť lead study author Melissa Danielson, a statistician with the U.S. Centers for Disease Control and Prevention, told NBC News.
Prescriptions for ADHD have been increasing since 2016, according to the CDC researchers, who used insurance data on prescription medication for that year through 2021 in people ages 5 to 64.
The study, published March 31 in the CDC publication Morbidity and Mortality Weekly Report, noted that prescriptions filled for stimulant medication increased to 4.1% in 2021 from 3.6% in 2016 among those enrolled in employer-sponsored insurance.
The increase was even more pronounced in certain age groups: Among adolescent and adult females ages 15 to 44 and males ages 25 to 44, prescriptions grew 10% from 2020 to 2021.
They also rose nearly 20% among females in an even narrower age range, 20 to 24.
The medications tracked in the analysis were stimulants sold under the brands Dexedrine and Adderall, methamphetamine under the brand Desoxyn, and methylphenidate, known as Ritalin.
A few factors may play into the increases, including greater awareness about symptoms, particularly symptom differences in women; an increase in all mental health diagnoses during the pandemic, and increased access because of changes in how ADHD is diagnosed, NBC News reported. Telehealth may also have played a role.
â€śPeople tend to seek out diagnoses during times of stress and crisis, and we have anecdotal evidence that there was a significant increase in people seeking diagnoses during the pandemic,â€ť Joshua Langberg, an ADHD specialist and director of the Center for Youth Social Emotional Wellness at Rutgers University in New Jersey, told NBC News.
The changes in how ADHD is diagnosed were due to a 2013 update in guidelines in the Diagnostic and Statistical Manual of Mental Disorders.
Among the changes included are ADHD symptoms starting later, at age 12 rather than at age 7, to be eligible for a diagnosis, NBC News reported.
Adults also need to have fewer symptoms to qualify. Generally, symptoms of ADHD are inattention, hyperactivity-impulsivity, not following through on instructions, not paying close attention to details, losing things and talking excessively.
Mental health providers also saw patients via telehealth during the pandemic and prescribed stimulants without seeing patients in person, NBC News reported.
â€śThat increased access allowed some people who had flown under the radar, or who said they were doing well enough, to get help,â€ť J. Russell Ramsay, director of the Adult ADHD Treatment and Research Program at the University of Pennsylvania's Perelman School of Medicine, told NBC News.
Ramsay said there has been both over- and underdiagnosis of the disorder.
â€śA comprehensive evaluation for ADHD is time-consuming, can be costly and it involves not just assessing for ADHD, but other things that can lead to concentration issues such as anxiety, depression and lack of sleep,â€ť he explained.
Providers sometimes have limited resources to take this into account, and some telehealth companies and pharmacies are being investigated for potentially overprescribing ADHD medication, NBC News reported.
â€śBecause ADHD occurs with other mental health disorders half the time, you have to make sure one of those is not causing symptoms of ADHD,â€ť Dr. Lenard Adler, director of the Adult ADHD Program at NYU Langone, told NBC News. â€śYou have to take a careful history.â€ť
The American Psychiatric Association has more on ADHD.
SOURCES: Morbidity and Mortality Weekly Report, March 31, 2023; NBC News