Many adults in the United States are prescribed medications such as amphetamines, which are at risk of misuse, along with medications for depression and anxiety, a new study finds.
The authors say this practice increases the incidence of misuse and addiction and can lead to unknown side effects.
Amphetamines and methylphenidate are classified by the Drug Enforcement Administration as: Schedule II Controlled Substancesthe same designation given to cocaine, OxyContin and fentanyl.
These drugs, which stimulate the body’s nervous system, are prescribed for a variety of conditions such as ADHD, sleep disorders, and nasal congestion, but are also used in combination with other drugs to treat disorders such as depression and anxiety. It is sometimes prescribed off-label for this reason. An off-label prescription is a drug prescribed for a purpose other than its approved use.
The study’s lead author, Thomas Moore, a researcher at Johns Hopkins University’s Center for Drug Safety and Efficacy, said prescription stimulants are “very potent” and that there is data on their use. “I am concerned given the risks of these drugs,” he said. Concomitant use with other psychiatric drugs is limited.The study was announced Monday BMJ Open.
“These drugs have a high potential for physical and psychological dependence,” he said. The use of prescription stimulants in combination with other drugs appears to be on the rise, he said.
The findings are based on claims data from over 9.1 million adults with private health insurance between October 1, 2019 and December 21, 2020.
Prescription stimulant use was defined as adults who filled one or more stimulant prescriptions containing the active ingredients of Ritalin, amphetamine and methylphenidate.
Researchers found that more than 276,000 adults are using Schedule II prescription stimulants. Of those adults, just under half (about 45%) used the drug along with other psychiatric medications such as antidepressants, antianxiety medications, and opioids.
Some doctors may prescribe stimulants to treat or enhance the side effects of another psychiatric drug. This is sometimes called the “prescription cascade,” Moore said.
“Patients are prescribed antidepressants, but perhaps one of the side effects is sedation, so stimulants such as amphetamines are added,” he said. “Alternatively, the effect of the drug is fairly modest, so adding an amphetamine may provide a little more benefit.”
Is depression linked to ADHD?
Robert Bassett, deputy medical director of the Center for Poison Control at Children’s Hospital of Philadelphia, said it’s common for conditions like depression to exacerbate another mental disorder.
“If depression is exacerbated or untreated, symptoms of depression can make it difficult to concentrate, and symptoms of ADHD can be exacerbated,” he said.
The survey found that 52.6% of women used both stimulants and other psychiatric medications, compared to 36.2% of men.
Furthermore, younger people, especially those aged 19 to 34, were more likely to use multiple medications than older people.
Amphetamine products accounted for 86.4% of stimulant prescriptions and methylphenidate products accounted for 13.6% of prescriptions.
Dr. Scott Hadland, an addiction expert at the Mass General for Children in Boston, who was not involved in the study, emphasized “caution” when interpreting the study results.
This study looked at how common it was for people to receive prescribed stimulants in addition to another psychiatric medication, and whether people misused or became dependent on these medications. was not investigated.
He also notes that prescription rates for stimulants like Adderall are generally rising in the United States, so it’s likely someone will take more than one drug at a time.A study published in 2021 found that Use of prescription stimulants Between adults from 2013 to 2018.
“It’s not uncommon for people with ADHD to have another condition like depression,” he said.
Moore said he was concerned about the practice because there aren’t enough clinical trials using stimulants alongside medications for conditions like depression and anxiety. People may experience unpleasant side effects or misuse the drug.
“There is little scientific information about whether this practice is safe and effective,” Moore said.
He said the study relied on private health insurance data, which may not be representative of people enrolled in government health programs like Medicare or Medicaid, or those without insurance. It pointed out.
Physicians should prescribe the lowest effective dose possible, Bassett said.
Hadland, Mass General for Children, said doctors should make sure they are prescribing stimulants “appropriately” and know about any other medications patients may be taking. rice field.
