Miércoles 28 de Septiembre de 2005, Ip nº 128

Use of Attention-Deficit Drugs Is Found to Soar Among Adults
Por GARDINER HARRIS

The use of drugs to treat attention-deficit hyperactivity disorder in younger adults more than doubled from 2000 to 2004, and spending on the drugs in the same age bracket, 20 to 44, more than quadrupled, a major prescription management company is reporting today.

The pills are also becoming increasingly popular among women. Indeed, adult women are now just as likely as men to take them, said the company, Medco Health Solutions. Among children, use by boys is nearly three times as likely as by girls.

One percent of adults ages 20 to 64 now take the drugs, according to Medco, which administers pharmaceutical benefits for managed care companies.

"I think this shows a clear recognition and new thinking that treatment for A.D.H.D. does not go away for many children after adolescence," said Dr. Robert S. Epstein, the company's chief medical officer.

Dr. James McGough, a professor of clinical psychiatry at the University of California, Los Angeles, said more adults should probably be taking the pills. A recent study by Harvard researchers found that as many as 4 percent of adults had symptoms of the disorder, Dr. McGough noted. Of the Medco report, he said, "I think it's a good sign that this is increasingly recognized and people are getting help."

But Dr. Alexander Lerman, a New York specialist in child and adolescent psychiatry, said psychiatrists were using increasingly vague definitions of the disorder to conclude that adults with mild symptoms needed medication. For those who truly need the medicines, Dr. Lerman said, they can be highly useful. For others, the drugs, which are generally stimulants, can cause even more problems, he said.

"I think this is a very mixed bag," Dr. Lerman said. "Stimulants are mood destabilizers. They make people more emotionally unstable, depressed, irritable, less social and obsessive."

Use of the drugs, among them Ritalin, Concerta and Adderall , in children has long been controversial. But in recent years, with drug companies developing newer, more expensive versions of those medicines, marketing to adults as well has increased.

Studies have shown that the pills can increase the concentration of almost anyone, and they are widely used by college students hoping to do well on exams. Dr. Epstein, of Medco, said the company had not broken down the increase in use to determine how much of it was sporadic. Nor was he able to say how many prescriptions were going to adults with new diagnoses, as opposed to those who had been taking the pills as children.

Dr. Lawrence Diller, a behavioral developmental pediatrician in Walnut Creek, Calif., pointed out that stimulants often promoted weight loss, which could be one explanation for their increasing use.

The use of medications for attention-deficit disorder grew faster from 2000 to 2004 than the use of any other class of medication except treatments for rheumatoid arthritis, the Medco study found.

Use of the attention-deficit drugs grew most rapidly in Kentucky, Tennessee, Alabama and Mississippi, Medco said. In those states, the drugs' use among adults rose 117 percent in the four-year period, the company said, compared with a 70 percent increase in pediatric use.

The share of adults ages 20 to 44 who obtained prescriptions for attention-deficit drugs rose to 1 percent in 2004 from roughly 0.5 percent in 2000. The share of children taking the drugs rose to 4.4 percent from 2.8 percent.

More expensive, brand-name drugs, instead of generic, accounted for 78 percent of the prescriptions in 2004, up from 60 percent in 2000. This rise helped fuel a 325 percent increase in spending on the medications, Medco said.


  15/09/2005. The New York Times.