Why do children with ADHD discontinue their medication?

OBJECTIVE

To examine factors associated with parent-reported discontinuation of attention-deficit/hyperactivity disorder (ADHD) medication.

METHODS

The authors conducted a telephone survey of parents of children 6 to 18 years old who had recently initiated ADHD medication according to insurance claims.

RESULTS

A total of 127 parents of children with ADHD who had recently initiated ADHD medication completed the survey (43% response rate); 21% discontinued the ADHD medication. Parents of discontinuers were less likely to report having discussed the risks and benefits of ADHD medication with primary care providers (59% vs 82%, P = .03) and were more likely to report psychological side effects (58% vs 21%, P > .001). Multivariate analyses demonstrated that both psychological side effects and perceived inadequate medication effectiveness were associated with discontinuation.

CONCLUSIONS

Many children discontinue ADHD medication within the first year, often because of psychological side effects or perceived inadequate medication effectiveness. Improved methods for psychological side effect management, setting realistic medication goals, and assessing therapeutic success are needed.