Concomitant Pharmacotherapy of Psychotropic Medications in EU Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

BACKGROUND: With preliminary data suggesting an increasing trend in attention-deficit/hyperactivity disorder (ADHD) prevalence in Europe, the use of psychotropic medications in this population needs to be better understood, particularly among patients with ADHD and no co-morbid psychiatric disorder. METHODS: Medical charts of patients aged 6–17 years with one or more ADHD diagnosis between January 1, 2004 and June 30, 2007, and use of ADHD medication were abstracted by physicians from six European countries. Patients with a history of epilepsy or diagnosis of Tourette syndrome were excluded. RESULTS: Among a convenience sample of 569 children/adolescent patients (mean age, 12.1 years), 80 (14.1 %) patients used psychotropic concomitant medication (PCM) along with their current on-label ADHD medication. The number of pre-existing co-morbidities, high impairment due to the symptom of anger, and country (France; Italy; the Netherlands; and Spain vs. the reference country, Germany) were significantly associated with PCM use (UK was not significantly different vs. Germany). In particular, in France, Italy, the Netherlands, and Spain, PCM use was highest. CONCLUSIONS: These findings suggest that greater attention to the use of PCM, which are not indicated for the treatment of ADHD, may be warranted in children and adolescents receiving PCM. This highlights the need for further research to assess the impact of PCM use in ADHD patients and to consider alternative, individualized, indicated treatment strategies for patients with ADHD.