Cantwell Etain, Nelan Ivana, Idid Sharifah Zahirah, McCarthy Suzanne, Driscoll David O
School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.
Specialist Neurodevelopmental ADHD Pathway, Cork and Kerry Mental Health Services, Cork, Ireland.
Int J Clin Pharm. 2025 Sep 1. doi: 10.1007/s11096-025-01979-z.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition, which initially presents in childhood. While prescribing trends for treating ADHD have been previously examined in Ireland's paediatric population, off-label prescribing of ADHD medication has yet to be studied.
We aimed to describe ADHD medication prescribing and off-label prescribing of ADHD medication in Ireland.
This cross-sectional study used a sample drawn from the population of children and adolescents who were attending mental health services in Ireland as of 31st December 2021. Participants were included based on predefined inclusion and exclusion criteria; those who were aged 17 years or younger and had been prescribed at least one psychotropic medication (n = 3,193). We described the frequency and population of those prescribed an ADHD stimulant or non-stimulant medication and the target condition or target symptom cluster for prescription. We reported the starting and maintenance doses of each medication.
Fifty-three percentage (n = 1,687) of children and adolescents were prescribed an ADHD medication on 31st December 2021, with more boys being prescribed an ADHD medication compared to girls (n = 1,284 vs n = 395). The most common age category prescribed ADHD medication was 11-13 years of age. The most common indication for prescribing ADHD medication was the target condition ADHD (n = 1,661; 98.5%).Twenty-six patients (1.5%) were prescribed ADHD medication for target symptoms, most commonly depressive (n = 8) and behavioural disturbance symptoms (n = 8) (i.e., off-label prescribing of ADHD medication).
More than half of young people attending specialist mental-health services in Ireland were receiving an ADHD-specific medicine, and almost all prescriptions were tied to a confirmed ADHD diagnosis. Off-label use for other symptom clusters was rare (< 2%), indicating strong adherence to licensed indications but also highlighting the importance of continued surveillance to detect emerging off-label trends and to ensure prescribing remains evidence-based and patient-centred.
注意缺陷多动障碍（ADHD）是一种神经发育疾病，最初在儿童期出现。虽然之前已经研究过爱尔兰儿科人群中治疗ADHD的处方趋势，但ADHD药物的非标签处方尚未得到研究。
我们旨在描述爱尔兰ADHD药物的处方情况以及ADHD药物的非标签处方情况。
这项横断面研究使用了截至2021年12月31日在爱尔兰接受心理健康服务的儿童和青少年人群中的一个样本。根据预先定义的纳入和排除标准纳入参与者；年龄在17岁及以下且至少开具过一种精神药物的患者（n = 3193）。我们描述了开具ADHD兴奋剂或非兴奋剂药物的频率和人群，以及处方的目标疾病或目标症状群。我们报告了每种药物的起始剂量和维持剂量。
2021年12月31日，53%（n = 1687）的儿童和青少年开具了ADHD药物，与女孩相比，开具ADHD药物的男孩更多（n = 1284对n = 395）。开具ADHD药物最常见的年龄类别是11 - 13岁。开具ADHD药物最常见的指征是目标疾病ADHD（n = 1661；98.5%）。26名患者（1.5%）因目标症状开具了ADHD药物，最常见的是抑郁（n = 8）和行为障碍症状（n = 8）（即ADHD药物的非标签处方）。
在爱尔兰接受专科心理健康服务的年轻人中，超过一半正在接受ADHD特异性药物治疗，并且几乎所有处方都与确诊的ADHD诊断相关。用于其他症状群的非标签使用很少（<2%），这表明严格遵循许可的指征，但也突出了持续监测以发现新出现的非标签趋势并确保处方仍然基于证据且以患者为中心的重要性。
