Prescriptions for attention deficit hyperactivity disorder (ADHD) in England have experienced a remarkable surge, increasing by 18% year on year since the onset of the pandemic. This notable rise surpasses previously reported figures and reveals stark regional variations in prescribing rates across the country. The findings, published in BMJ Mental Health, shed light on evolving trends in ADHD management during a time marked by heightened public awareness and the psychosocial impacts of COVID-19.
ADHD is increasingly recognized as a common disorder affecting children globally, with an estimated prevalence of approximately 7%. This condition is not limited to the pediatric population; there is a growing recognition of its prevalence among symptomatic adults, which has also been reported to hover around the same rate. The combination of awareness and diagnosis through both conventional and non-traditional channels, including social media, appears to significantly contribute to the rising numbers of prescriptions.
In the UK, five medications have received approval for the treatment of ADHD. These comprise three stimulant drugs—methylphenidate, dexamfetamine, and lisdexamfetamine—and two non-stimulants, atomoxetine and guanfacine. The lack of access to effective alternative therapies, such as psychological or behavioral interventions, positions these pharmacological treatments as essential tools in managing ADHD. As prescription patterns evolve, there remains a critical need for ongoing evaluation of both pharmacologic and non-pharmacologic treatment modalities.
A number of studies have highlighted rising trends in ADHD prescriptions following the COVID-19 pandemic. However, many of these earlier investigations relied on the pre-reform NHS structure, which traditionally organized healthcare delivery, and often focused solely on specific patient demographics or prescription types. Therefore, there has been limited understanding of the broader factors influencing these prescribing behaviors. This latest research sought to fill that gap by examining prescription data spanning from April 2019 to March 2024, with particular attention to the five licensed ADHD medications at national, regional, and integrated care board (ICB) levels.
The analysis revealed a significant upward trajectory in ADHD prescriptions, escalating from roughly 25 items per 1,000 people during the 2019-20 period, just before the onset of the pandemic, to 41.55 items per 1,000 people by the 2023-24 period. This consistent annual growth of 18% captures a changing landscape in mental health treatment, one that is more attuned to the challenges posed by societal shifts and health crises.
Methylphenidate emerged as the most widely prescribed medication for ADHD, accounting for 19 items per 1,000 people. However, the most rapid growth occurred with lisdexamfetamine, which experienced an astounding 55% year-on-year increase, rising from 2.86 items per 1,000 people in the 2019-20 period to 8.68 items in 2023-24. This increased usage may be indicative of a transition toward personalized medicine, as clinicians and patients alike explore the most effective options for managing ADHD symptoms.
The increase in ADHD prescriptions was not uniform across England; significant regional disparities were observed. London experienced the highest annual growth rate at 28%, while regions such as the Northeast and Yorkshire exhibited the lowest increase, hovering at around 13%. Furthermore, Southeast England demonstrated a notable change, with an almost 19.5% rise in annual prescription rates. These findings underline the importance of analyzing regional healthcare practices and access, which may contribute to different levels of ADHD diagnosis and treatment.
At the ICB level, discrepancies in prescribing trends were even more pronounced. The NHS Birmingham and Solihull ICB recorded an exceptional 51.5% increase in ADHD prescriptions, highlighting the potential for localized health interventions. Meanwhile, the NHS Norfolk and Waveney ICB witnessed only a modest rise of just over 4.5%. Such variations indicate not only disparities in healthcare access but also suggest that local healthcare policies and resource allocation may significantly influence treatment availability and effectiveness.
Further statistical analysis unearthed significant associations between socioeconomic factors and prescribing trends for ADHD medications. This analysis pinpointed ethnicity and deprivation levels as critical elements in understanding the accessibility of ADHD care. Age and broader inequalities also emerged as noteworthy contributing factors. This intersection of variables paints a complex picture of how ADHD management is influenced by not just medical necessity, but also by society’s structure and the resources available within different communities.
The researchers postulate a combination of factors contributing to the marked rise in prescription rates. Greater public awareness, augmented by the influence of platforms like TikTok and Instagram, has likely incited an increasing number of individuals to pursue assessment and diagnosis for ADHD. However, this spike in awareness carries the potential downside of misinformation circulating on these same platforms, underscoring a pressing need for robust research on effective pathways for disseminating accurate diagnostic information.
The psychological turmoil, anxiety, and stress inflicted by the COVID-19 pandemic may also play a significant role in the escalating prescription rates. The therapy traditionally offered by psychological services became increasingly difficult to access during lockdowns, which in turn likely led to a higher reliance on pharmacological options for symptom management. This trend raises essential questions: Are these changes reflective of a temporary surge stemming from pandemic-related stressors, or do they signal a more permanent shift in how ADHD is treated in the post-pandemic world?
As a conclusion, the pronounced rise in ADHD prescriptions highlights an urgent call for policymakers to address the existing disparities in healthcare access. The data suggests that regional variance and socioeconomic status significantly influence the level of ADHD management available to affected populations. Future efforts should aim to evaluate the hurdles that certain regions face in providing adequate ADHD care and work toward developing targeted strategies to mitigate these disparities.
Subject of Research: People
Article Title: Socioeconomic status and prescribing of ADHD medications: a study of ICB-level data in England
News Publication Date: 11-Mar-2025
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Keywords: Attention deficit hyperactivity disorder, prescribing trends, ADHD medications, socioeconomic factors, mental health treatment, regional disparities.
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