ADHD Medication Use Rises Sharply Post-Pandemic

A new study by two academic pharmacists found a “substantial increase” in prescriptions for drugs to treat attention deficit hyperactivity disorder (ADHD) in England since 2019, exceeding previous reports.

The researchers suggested that the rise may be driven by growing awareness of the condition, partly stimulated by social media, and the ongoing mental health impact of COVID-19 pandemic restrictions, such as lockdowns, school and business closures, and social distancing. 

The study, published in BMJ Mental Health, was conducted by Dr Muhammad Umair Khan, PhD, lecturer in clinical pharmacy at Aston University, and Dr Syed Shahzad Hasan, PhD, senior research fellow at the University of Huddersfield. They highlighted regional disparities that they said demonstrated the complex interplay between socioeconomic factors and ADHD treatment access, which they suggested should help to shape targeted healthcare policies.

ADHD Prescriptions Rose by 18% Annually

The researchers analysed prescribing trends using figures published by the NHS Business Services Authority (NHSBSA) for April 2019 to March 2024.

They found that ADHD medication prescriptions increased from 25.17 items per 1000 people in 2019-2020 to 41.55 items per 1000 in 2023-2024. This represents an average annual increase of 18%.

Previous studies have identified a rise in mental health prescriptions. ADHD medication use has grown for decades due to increased awareness, expanded diagnostic criteria, and more treatment options. Research has also indicated a surge in ADHD drug use across Europe between 2021 and 2022 compared with 2014-2019.

A 2023 study based on NHSBSA figures showed a 16.4% increase in central nervous system stimulants and ADHD drugs combined in 2021-2022 compared with the previous year. Since 2015-2016, there has been a cumulative 63.3% rise in prescriptions. Patients from deprived areas accounted for 81.4% of prescriptions, and adult diagnoses rose by 400% over 3 years, particularly among women, who had been previously underrepresented. 

Pandemic Measures Worsened Mental Health

Khan and Hasan noted evidence suggesting that lockdowns and other pandemic measures had “resulted in increased anxiety, depression, family conflicts, loneliness, and post-traumatic stress disorder”. These included patients who reported worsening ADHD symptoms as well as increased demand for ADHD-related services, including use of medications.

Dr Ulrich Müller-Sedgwick, ADHD champion at the Royal College of Psychiatrists, told the Science Media Centre (SMC) that improved recognition of ADHD in women and greater public awareness of the condition had contributed to the rise in diagnoses. The impact of pandemic measures had “exacerbated many people’s symptoms”, he said.

Social media platforms such as TikTok and Instagram had likely played a role in encouraging people to seek ADHD assessments and treatment, Khan and Hasan said. 

Some psychiatrists are sceptical, viewing the rise as a fad. They query whether ADHD is being over-medicalised, particularly in North America and Western Europe, where fidgeting and inattentiveness in children are increasingly seen as conditions requiring medical intervention.

ADHD “Often Diagnosed Promiscuously”

The issue is made more complex as over half of ADHD patients have a concurrent psychiatric diagnosis such as anxiety, depression, autism, bipolar disorder, or psychosis. ADHD treatment may exacerbate untreated mood disorders, complicating care. 

Dr Paul Keedwell, consultant psychiatrist at Cardiff University, told the SMC that many mental health conditions can mimic ADHD symptoms. Autism, complex trauma, anxiety, and depression frequently co-exist with ADHD, so “there could be a degree of over-diagnosing”.

Baroness Fox of Buckley, a former community mental health practitioner, has highlighted the “slippage” between autism and mental illness. Speaking in the House of Lords in January, she called ADHD a “fashionable disorder” that is “often diagnosed promiscuously”.

Fox concurred with warnings about over-diagnosis, citing the 18% rise in prescriptions for ADHD drugs between April 2023 and March 2024. She said that experts were becoming “diagnostically trigger-happy”, labelling people as ill, and egging them on to demand “pills to help them to cope with the travails of life”.

Khan and Hasan stressed the need for clinicians to carefully assess patients before prescribing ADHD medication. They called for consideration of demographic and socioeconomic factors to optimise treatment.

Regional Disparities in Prescriptions

The study found significant variations in ADHD prescriptions across England. While the upward trend was observed in all seven regions, London had the highest annual increase at 28%, followed by Southeast England at nearly 19.5%. The Northeast and Yorkshire saw the lowest rise at 13%.

Prescription rates were also closely linked to socioeconomic factors, particularly ethnicity and deprivation. The researchers said these disparities points to inequalities in access to care and highlight a need for policies that improve equitable access to ADHD care.

Future research should focus on understanding the long-term effects of increased medication use on patient outcomes and healthcare costs. “It is crucial to determine whether these trends represent a temporary shift or a more permanent change,” the authors concluded.

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.