The number of adult women with prescriptions for medication to treat attention deficit disorder (ADHD) has increased by 344% from 2003 to 2015, according to a new CDC report.
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For the report, CDC researchers tracked prescriptions for ADHD-related medication for women ages 15 to 44 from 2003 to 2015, a sample that included over four million women.
The report found that the percentage of adult U.S. women with prescriptions for ADHD medication increased from 1% of the population in 2003 to 4% in 2015. While the rate of ADHD medication prescriptions increased among all age brackets for women between ages 15 and 44, it increased most significantly among young adult women, the report found—by 700% among women ages 25 to 29 and by 560% among women ages 30 to 34.
According to the researchers, the prescription rate increased most sharply in Southern and Western states. Overall, the researchers found that the AHDH medication prescription rate among women in the United States was higher when compared with earlier estimates for the United Kingdom or Canada. According to the report, the most commonly used ADHD medications were Adderall, Vyvanse, and Ritalin.
According to USA Today, the study found that most women taking ADHD prescriptions were using stimulant drugs—but there is relatively little research, and some of it is contradictory, on how such drugs might affect a pregnancy.
For instance, one study found that infants born to women using methylphenidate—a stimulant medication—during pregnancy were slightly more at risk for heart malformations. That said, the study did not find any association between amphetamines like Adderall and heart malformation risk, and an earlier study had not found any link between methylphenidate and significant heart malformations, USA Today reports.
The CDC report recommended further research into how such drugs might affect a pregnancy, noting that about half of pregnancies are unplanned and therefore may involve women continuing ADHD medication while unaware they are pregnant. Coleen Boyle, director of CDC's National Center on Birth Defects and Developmental Disabilities, said of the findings, "Early pregnancy is a critical time for the developing baby. We need to better understand the safest ways to treat ADHD before and during pregnancy."
According to USA Today, CDC did not assess what might be driving the increase in ADHD prescriptions among women. However, some experts believe it's because the general understanding of ADHD has changed significantly since the early-2000s.
According to Patricia Quinn—a developmental pediatrician in Washington, D.C. who specializes in ADHD in women and girls—about 5% of U.S. adults are believed to have ADHD, so this increase in prescriptions among women makes sense. "We're kind of catching up now," she said, adding that in the past men were diagnosed with ADHD 10-times more often than women.
Separately, Edward Hallowell, a psychiatrist, added, "The good news is that adult women are finally getting diagnosed. I see women go from struggling and feeling so bad about themselves to—they burst into tears when they see how much better their life becomes."
The rise in women taking ADHD medications is also likely related to an increase in childhood diagnoses of ADHD, according to Melissa Orlov, a marriage counselor who specializes in relationship issues in ADHD. These children being diagnosed with the condition are growing up and continuing to take their medication, she said.
In addition, many women also find out that they have ADHD—which is an inherited condition—after their child is diagnosed with it. "That seems to be the most common way that adults figure out they have it," she said.
That said, other experts cautioned that the increase should give clinicians pause before prescribing ADHD medication, particularly among adults who feel they are experiencing "adult-onset ADHD." According to the New York Times, the validity of that diagnosis is "fiercely debate[d]" among experts, and at least one study "concluded the disorder did not exist."
Margaret Sibley—an associate professor of psychiatry and behavioral health at Florida International University, who led that study—said, "If adult symptoms are being reported by patients, it shouldn't necessarily be immediately classified as ADHD. … A more careful evaluation often finds that there's something else causing the problems, like depression, or drug use—which is what we found" (Weintraub, USA Today, 1/18; Carey, New York Times, 1/18).
Women’s services face shifting demographics, including an aging and increasingly chronic, multi-morbid population and minimally growing births, that will continue to impact the demand for services.
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