Article date: June 2018
By: Vanessa Pauly, Elisabeth Frauger, Magalie Lepelley, Michel Mallaret, Quentin Boucherie, Joëlle Micallef in Volume 84, Issue 6, pages 1215-1227
Aim
The aim of the present study was to characterize patterns of use of methylphenidate (MPH), a prescription stimulant medication recommended in the treatment of attention deficit hyperactivity disorder (ADHD) and of narcolepsy, in France, both in children and adults, over a 3‐year period.
Methods
Using the French General Health Insurance database, limited to two areas covering approximately 4 million individuals, we made up a cohort of incident MPH users between July 2010 and June 2013. Splitting them into distinct age groups (18–24, 25–49 and ≥50 years of age for adults and <6, 6–11 and 12–17 years of age for children), we established the characteristics of these populations at MPH initiation and during follow‐up according to the duration of treatment, quantities dispensed and coprescription with central nervous system (CNS) drugs.
Results
We included a cohort of 3534 incident users, involving 30 238 dispensings of MPH, leading to an annual rate of 29 incident users per 100 000 in 2013. Children (66% of new users) were characterized by long‐term use of MPH with few comedications. The group of 25–49‐year‐old patients were dispensed MPH more frequently than other groups, had the highest mean dose and were more often coprescribed other CNS drugs. The ≥50 year‐old group was more often coprescribed antidepressants and antiparkinsonian drugs.
Conclusions
Our pharmacoepidemiological study involving incident MPH users with a large number of characteristics showed different patterns of MPH use among children and adults. The results from the 25–49‐year‐old group suggested that MPH might be being used for medical conditions other than ADHD or narcolepsy in adults, and that it might be subject to misuse and/or abuse.
DOI: 10.1111/bcp.13544
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