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. 2022 Jul;31(7):810-814.
doi: 10.1002/pds.5445. Epub 2022 May 3.

Trends in antipsychotic use for youth with attention-deficit/hyperactivity disorder and disruptive behavior disorders

Susan dosReis  1 , Jannat Saini  1 , Kyungwan Hong  1 , Gloria Reeves  2 , O' Mareen Spence  1
Affiliations

Trends in antipsychotic use for youth with attention-deficit/hyperactivity disorder and disruptive behavior disorders

Susan dosReis et al. Pharmacoepidemiol Drug Saf. 2022 Jul.

Abstract

Purpose: To examine trends in off-label antipsychotic use for youth with attention-deficit/hyperactivity disorder with and without a comorbid disruptive behavior disorder.

Method: This cross-sectional study of annual trends from 2007 through 2015 used the IQVIA PharMetrics® Plus for Academics data. We identified 165 794 commercially-insured youth 3-18-year-old who had a diagnosis of attention-deficit/hyperactivity disorder and classified them into subgroups with and without disruptive behavior disorders comorbidities. Antipsychotic use, with or without a stimulant, was the primary dependent outcome. Logistic regression estimated the odds of antipsychotic use associated with comorbid attention-deficit/hyperactivity disorder and disruptive behavior disorders, adjusting for age, sex, study year, and other psychotropic use.

Results: Over 70% of the 165 794 youth with attention-deficit/hyperactivity disorder were 5-14-year-old and male, and 12% had disruptive behavior disorders. Antipsychotic prevalence, with or without a stimulant, was 4.4% in 2007 and 3.4% in 2015. Stimulants with antipsychotics increased significantly from 2007 to 2015 for females (19.5%-28.7%) and youth 15-18-year-old (25.9%-32.7%). Adjusting for age, sex, study year, and other psychotropic use, youth with a comorbid disruptive behavior had a 2.5 (95% CI: 2.3, 2.7) higher likelihood of receiving an antipsychotic than youth with attention-deficit/hyperactivity disorder and no comorbidities.

Conclusions: Antipsychotic use was associated with comorbid disruptive behaviors in youth with attention-deficit/hyperactivity disorder. Off-label antipsychotic use has increased for females and older adolescents.

Keywords: ADHD; antipsychotic; comorbidities; disruptive behavior disorder; off-label.

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References

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