Open AccessCurrent use of attention-deficit hyperactivity disorder (ADHD) medications and clinical characteristics of child and adolescent psychiatric outpatients prescribed multiple ADHD medications in Japan
Author(s) -
Yoko Sasaki,
Noa Tsujii,
Shouko Sasaki,
Hikaru Sunakawa,
Yusuke Toguchi,
Syuuichi Tanase,
Kiyoshi Saito,
Rena Shinohara,
Toshinari Kurokouchi,
Kaori Sugimoto,
Kotoe Itagaki,
Yukino Yoshida,
Saori Namekata,
Momoka Takahashi,
Ikuhiro Harada,
Yuuki Hakosima,
Kumi Inazaki,
Yukari Yoshimura,
Yuki Mizumoto,
Takayuki Okada,
Masahide Usami
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0252420
Subject(s) - attention deficit hyperactivity disorder , atomoxetine , psychiatry , methylphenidate , impulsivity , medicine , rating scale , pediatrics , child and adolescent psychiatry , clinical psychology , psychology , developmental psychology
Background/aim Patients with attention-deficit hyperactivity disorder (ADHD) manifest symptoms of hyperactivity, impulsivity, and/or inattention. ADHD medications available in Japan are limited compared with those in Western countries. Prescribing status has not been sufficiently evaluated in clinical settings in Japan. This study investigated the current use of ADHD medications and characteristics of patients who received multiple ADHD medications in a clinical setting in Japan. Methods Study participants were those who visited the Department of Child and Adolescent Psychiatry, Kohnodai Hospital between April 2015 and March 2020. We investigated patients who received osmotic-controlled release oral delivery system methylphenidate, atomoxetine, or guanfacine. A retrospective case–control design was used to evaluate the characteristics of patients who received multiple ADHD medications. Patients who were given three ADHD medications were defined as the case group. Randomly sampled sex- and age-matched patients diagnosed with ADHD were defined as the control group. We compared data for child-to-parent violence, antisocial behavior, suicide attempt or self-harm, abuse history, refusal to attend school, and two psychological rating scales (the ADHD-Rating Scale and Tokyo Autistic Behavior Scale). Results Among the 878 patients who were prescribed any ADHD medications, 43 (4.9%) received three ADHD medications. Logistic regression revealed that children with severe ADHD symptoms, autistic characteristics, or tendency of child-to-parent violence were more likely to have been prescribed three medications during their treatment. Conclusions Our findings suggest the approach to prevent the use of multiple ADHD medications. A prospective study to investigate the causality between prescribing status and clinical characteristics is warranted.