ADHD and central nervous system stimulant prescribing nearly doubles in adults in three years

The number of adults in England prescribed at least one medicine for attention deficit hyperactivity disorder (ADHD) or a central nervous system (CNS) stimulant has nearly doubled since the start of the COVID-19 pandemic, data obtained by The Pharmaceutical Journal have revealed.

NHS data, obtained through a freedom of information request to NHS Business Services Authority (NHS BSA), show that the number of adults prescribed central nervous system (CNS) stimulants and drugs used for ADHD increased by 91% between January 2020 and January 2023, from 37,844 patients to 72,376 patients, respectively.

The increase means that more adults than children are now being prescribed ADHD medicines.

The data also revealed that the number of females being prescribed these medicines has risen more quickly than the number of males, with 129% more women prescribed CNS stimulants and drugs used for ADHD in January 2023 (31,664) than in January 2020 (13,797).

Meanwhile, the number of men taking CNS stimulants and drugs used for ADHD increased by 69% over the same period, from 24,047 men in January 2020 to 40,712 in January 2023.

In March 2023, NHS BSA said that the total number of patients prescribed these medicines increased by almost 85% in the five years between 2017 and 2022.

ADHD was not formally recognised as a condition by the NHS until 2000 in children and 2008 in adults.  

Commenting on the analysis, Peter Carpenter, chair of the Royal College of Psychiatrists’ neurodevelopmental psychiatry special interest group, said: “The fact that more adults are now being prescribed medication than children underpins the fact that, in a high percentage [of people], ADHD continues into adulthood but also that many people will have struggled with undiagnosed ADHD for decades and are only seeking help now.”

Carpenter added that the increasing diagnostic rate for ADHD, “while a stride in the right direction”, is placing NHS mental health and primary care services under unprecedented strain.

“It is essential to stress that these newly diagnosed cases necessitate appropriate follow-up and aftercare,” he said.

“We urgently require an infusion of resources into these services to not only manage the burgeoning waiting lists for assessments but also to ensure timely and high-quality post-diagnostic care to manage this surge effectively.”

Beryl Navti, clinical lead pharmacist for child and adolescent mental health services at North East London NHS Foundation Trust, warned that the increase in adult diagnoses is having consequences for young people as they reach the age of 18 years and are transferred to adult services.

“In some areas, GPs are unable to continue prescribing for young people waiting to be seen by adult ADHD services, and many children’s ADHD services cannot continue prescribing for over 18s, leaving a gap in treatment for these young people, putting them at significant risk,” she said.

Commenting on the increase in ADHD prescribing in women, Henry Shelford, chief executive of charity ADHD UK, said: “There’s a much larger proportional overhang of undiagnosed women because the pick-up rate in school for girls is so much lower.”

“Many talk of a ‘spike’ in assessment demand. However, it is not a spike. It is a fundamental change that requires a permanent shift in resourcing,” he said, adding that only a fraction of the estimated 1.9 million adults and 700,000 children living with ADHD in the UK receive a diagnosis.

ADHD UK routinely hears of children waiting two to three years for assessments and of no adult assessment provision being available in some areas, Shelford added.