Young Women Are Using A.D.H.D. Drugs in Greater Numbers, C.D.C. Reports

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Women are filling prescriptions for A.D.H.D. drugs like Adderall in growing numbers, government researchers report. The finding raises questions about an uptick in diagnoses once reserved only for children and adolescents. Credit Elizabeth D. Herman for The New York Times

The percentage of young adult women who filled prescriptions for drugs used to treat attention deficit disorder has increased more than fivefold since 2003, the Centers for Disease Control and Prevention reported on Thursday.

The new report raises questions about the increasing use of a diagnosis that once was reserved for children and adolescents.

Government researchers tracked prescriptions for drugs to treat A.D.H.D., like Adderall and Vyvanse, among women aged 15 to 44 between 2003 and 2015. The sample included more than 4 million women per year, on average, all of whom had private insurance with drug coverage.

A.D.H.D. prescription rates increased sharply in all age groups during that period, but most steeply among young adult women: by 700 percent among women aged 25 to 29, and by 560 percent among women aged 30 to 34.

Between 3 percent and 6 percent of adult women in various age groups got these prescriptions in 2015, the researchers found, compared with 1 percent or less in 2003. The rate rose among women ages 20 to 24, for example, to 5.5 percent in 2015 from 1 percent in 2003.

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The most commonly used A.D.H.D. drugs among women were Adderall, Vyvanse and Ritalin, the study found.

The report broke down prescription rates by region, finding the largest increases in Southern and Western states. Overall rates were sharply higher in the United States, compared with previous estimates in the United Kingdom or Canada.

This difference “might reflect higher A.D.H.D. medication prescribing in the United States or differences in the types of A.D.H.D. medications” used in these countries, the authors concluded.

The findings come as rising prescription rates for psychiatric drugs are receiving increasing scrutiny.

For decades, experts have questioned the increase in A.D.H.D. diagnoses among children and adolescents. The rates far outstrip estimated prevalence of the disorder, and the first-line treatment is almost always a prescription for stimulant medication.

The new study suggests that the increase has happened among adults, too.

Recent changes in diagnostic guidelines have extended the criteria to adults who have experienced inattentiveness and restlessness since childhood. Psychiatrists generally accept longstanding A.D.H.D. as a valid, treatable disorder in adults.

But many also acknowledge that these drugs have wide appeal as performance-enhancers: among students as study aids, and among adults seeking an edge in their work.

Yet prevalence studies, using strict criteria, estimate that around 3 percent of adult women overall have A.D.H.D., well under the 5 percent and higher rates recorded in some age groups by the C.D.C.

The new study is also relevant to more recently proposed diagnosis: adult-onset A.D.H.D., in which symptoms emerge out of blue, well after adolescence. Experts fiercely debate whether this diagnosis is valid, and a recent study concluded that the disorder did not exist.

“If adult symptoms are being reported by patients, it shouldn’t necessarily be immediately classified as A.D.H.D.,” said Margaret Sibley, an associate professor of psychiatry and behavioral health at Florida International University, the lead author of that study.

“A more careful evaluation often finds that there’s something else causing the problems, like depression, or drug use — which is what we found.”

The C.D.C. report looked only at numbers of prescriptions and not at the types of diagnoses to justify them.

The study also raises concerns specific to women, according to Coleen Boyle, director of the C.D.C.’s National Center on Birth Defects and Developmental Disabilities.

“Half of all pregnancies in the United States are unplanned, and women may be taking prescription medicine early in pregnancy before they know they are pregnant,” Dr. Boyle said in a prepared statement.

“Early pregnancy is a critical time for the developing baby. We need to better understand the safest ways to treat A.D.H.D. before and during pregnancy.”