Karlstad Øystein, Zoëga Helga, Furu Kari, Bahmanyar Shahram, Martikainen Jaana E, Kieler Helle, Pottegård Anton
Department of Pharmacoepidemiology, Norwegian Institute of Public Health, P.O.box 4404 Nydalen, 0403, Oslo, Norway.
Centre of Public Health Sciences, Faculty of Medicine, University of Iceland Reykjavik, Reykjavik, Iceland.
Eur J Clin Pharmacol. 2016 Dec;72(12):1507-1514. doi: 10.1007/s00228-016-2125-y. Epub 2016 Sep 1.
The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries.
We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18-64 years during 2008-2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants.
Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men.
Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed.
成人使用注意力缺陷多动障碍（ADHD）药物存在争议，且直到最近，大多数国家仍未批准其用于成人。本研究旨在调查北欧国家全体成年人群中ADHD药物（兴奋剂和托莫西汀）的使用情况。
我们开展了一项基于北欧五国（丹麦、芬兰、冰岛、挪威和瑞典）全体成年人群的跨国处方登记研究。纳入了2008年至2012年期间年龄在18至64岁的所有ADHD药物使用者，2012年这一群体在1580万成年居民中共有76896名药物使用者。
在研究期间，男女各年龄组的药物使用年患病率均有所上升。总体患病率从每1000名男性中的2.4例增至5.3例，每1000名女性中的1.8例增至4.4例。发病率也有所上升，但在研究期的最后阶段增幅较小。88%的药物使用者使用哌甲酯。21%的新药物使用者在第一年就停止了治疗。在所有ADHD药物使用者中，53%的男性和64%的女性同时使用其他精神药物，最常见的是抗抑郁药和催眠药。精神药物联合用药随年龄增长而增加，在女性中比在男性中更为明显。
成人ADHD药物的使用在5年内增加了一倍多，且大多数人同时接受其他精神药物治疗。成人在接受ADHD药物治疗的人群中占相当大的比例。因此，迫切需要有关成人长期疗效和安全性的证据。
