Trends in use of attention deficit hyperactivity disorder medication among children and adolescents in Scandinavia in 2010-2020

Eur Child Adolesc Psychiatry. 2023 Oct;32(10):2049-2056. doi: 10.1007/s00787-022-02034-2. Epub 2022 Jul 13.

Abstract

The objective of the study was to compare the use of attention deficit hyperactivity disorder (ADHD) medication among children and adolescents in Scandinavia 2010-2020. Using aggregated prescription data for individuals aged 5-19 years, we calculated annual prevalence proportions of ADHD medication (users/1000 inhabitants) for each country, overall and stratified by age and sex. Overall, use of ADHD medication increased during 2010-2020 in all countries. The increase was pronounced in Sweden reaching 35 users/1000 inhabitants in 2020 (119% increase), whereas it reached 22/1000 in Denmark and Norway (equivalent to a 38% and 16% increase, respectively). Methylphenidate was the most frequently used drug and Sweden had the highest use reaching 25/1000 in 2020 compared to 16/1000 and 18/1000 in Denmark and Norway, respectively. Lisdexamfetamine use increased steadily and was also highest in Sweden (13/1000 in 2020). In 2020, atomoxetine use was higher in Sweden (4.6/1000) and Denmark (4.5/1000) compared to Norway (2.2/1000). From 2015, use of guanfacine increased in Sweden reaching 4.4/1000 in 2020 but remained low in Denmark (0.4/1000) and Norway (0.7/1000). Use of dexamphetamine was low (ranging from 0.47 to 0.75/1000 in 2020) in the three countries. ADHD medication use was highest in Sweden across all age groups. In all countries, the prevalence was higher in males compared to females. In conclusion, use of ADHD medication among children and adolescents in Scandinavia is increasing. The prevalence of use is higher in Sweden for all drug groups compared to Norway and Denmark.

Keywords: ADHD; Adolescents; Children; Drug utilization; Scandinavia.

MeSH terms

  • Adolescent
  • Atomoxetine Hydrochloride / therapeutic use
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Central Nervous System Stimulants* / therapeutic use
  • Child
  • Female
  • Humans
  • Male
  • Methylphenidate* / therapeutic use
  • Scandinavian and Nordic Countries / epidemiology

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride