June 18, 2012— -- The number of children who received prescriptions for drugs used to treat attention deficit hyperactivity disorder (ADHD) increased over an eight-year period while the number of antibiotic prescriptions declined, according to a new study by the Food and Drug Administration.
Using a large national database, FDA researchers analyzed prescription drug trends among children ages up to age 17 between 2002 and 2010 on an outpatient basis.
The study, published in the journal Pediatrics, found that the number of overall prescriptions for this age group decreased by 7 percent, in contrast to the 22 percent increase in prescriptions given to adults over the same period. However, the authors noted that their research did not track whether the drugs were actually used, only that they were prescribed.
There were also significant decreases in the number of antibiotics, allergy medicines, pain medicines, drugs used to treat depression and certain cough and cold medications prescribed for children.
But ADHD prescriptions increased by 46 percent, and there were also higher numbers of medications prescribed for asthma and birth control.
"Identification of drugs with the highest numbers of patients exposed can help focus research efforts on those drugs that could have a large impact on the pediatric population, " wrote the authors, led by Grace Chai of the FDA's Center for Drug Evaluation and Research.
Contraceptive prescriptions also skyrocketed, increasing among adolescents by 93 percent.
The study did not offer in-depth analysis of reasons behind these trends, but the authors did suggest that birth control use could actually be explained by a number of factors. Recent surveys did not find much of an increase in the number of girls using birth control, so the trend may be the result of longer use or using these medications for other reasons, such as acne.
They also found that a considerable number of infants less than 1 year old were prescribed acid reflux-controlling proton pump inhibitors -- particularly Prevacid -- although these medications are not FDA-approved for use in children this young.
On the other hand, antibiotic use decreased by 14 percent, and the authors suggest that large-scale efforts by the American Academy of Pediatrics and other children's health experts to decrease antibiotic use "by educating parents about the futility of treating viral infections with antibiotics and about concerns of antibiotic resistance" have been successful.
Similarly, the number of antidepressant prescriptions for children declined. Dr. Martin Stein, a professor of pediatrics at the University of California, San Diego School of Medicine attributed much of the decrease to FDA warnings about certain drugs.
"The reason for the warnings was there was a two-fold increase in suicidal ideation, particularly in the first month after initiating therapy with selective serotonin reuptake inhibitors," he said. Stein was not involved in the FDA study.
"This trend, however, is a double-edged sword," he added. "More children are likely to attempt suicide when they are depressed if they are not appropriately treated."
Ritalin and other ADHD drugs like Adderall account for most of the ADHD drug prescriptions between 2002 and 2010, but the researchers noted use of these medications is stabilizing and being replaced by newer drugs, such as Vyvanse and Focalin.
Ritalin was the drug most often given to adolescents, the authors found.
Stein explained that the considerable increase in the number of prescriptions for ADHD drugs is due to a higher number of diagnoses.
According to the Centers for Disease Control and Prevention, the number of children diagnosed with ADHD increased from 4.4 million to 5 million between 2002 and 2010.
Many of those children, according to Stein, may have been misdiagnosed.
"It's not a slam-dunk diagnosis," he said. "The most important thing is to get the diagnosis right, and there are very strict criteria that must be met."