Prescription Patterns in Adult ADHD: The Reality at CHUC
DOI:
https://doi.org/10.51338/rppsm.476Keywords:
Adult, Attention Deficit Disorder with Hyperactivity/drug therapy, Lisdexanfetamine, MethylphenidateAbstract
Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders, affecting around 2%‑4% of the adult population. The first‑line therapeutic intervention is psychostimulants such as methylphenidate and amphetamines. Second‑line therapy is used when stimulants are ineffective, intolerant, or contraindicated.Methods: Retrospective observational study of patients followed up at the Neurodevelopment Consultation at the Psychiatry Service of Coimbra Hospital and University Centre (CHUC), covering 2 years and 9 months of activity (January 2019 to September 2021) with a diagnosis of ADHD, to characterize the sample from a sociodemographic point of view and psychopharmacological prescription. Data was collected in September 2021 using SClínico. Data processing in Excel (version 16.46).
Results: The sample included 416 patients, 82 of whom were diagnosed with ADHD. The study found that 73% of the participants were male, with an average age of 21. Of the patients diagnosed with ADHD, 52.4% had the diagnosis isolated, while 47.6% had ADHD in comorbidity with another psychiatric condition. As for psychopharmacological prescriptions, 65.9% were medicated with methylphenidate, 46.3% with the maximum dose (54 mg once a day), and 7.4% with 36 or 40 mg once a day in both cases, with other doses prescribed less frequently.
Conclusion: Recent international studies report a prevalence of 90%‑92% of methylphenidate prescriptions in ADHD patients, with the reality of CHUC being lower (65.9%) than the international reality. This prevalence may be due to intolerance of adverse effects, low therapeutic adherence, or the presence of multiple comorbidities, which can lead to a decrease in prescriptions. Prescriptions should always be individualized and in accordance with the psychopathology presented. More studies are needed to assess the reality of Portuguese prescribing.
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