Psychiatric medication use soaring among women: Report

By Dr. Ananya Mandal, MDNov 17 2011

Women’s use of ADHD medication rose 250% in a decade

Attention Deficit Hyperactivity Disorder or ADHD commonly affects boys more than girls. However a new report shows that among adults, the numbers have changed with women’s use of ADHD medications risen over the past decade surpassing that of men.

Researchers noted that from 2001 to 2010, the number of American women ages 20 to 44 who took ADHD drugs skyrocketed more than 250 percent, according to the report from Medco Health Solutions. Researchers analyzed trends in the use of mental health medications among about 2.5 million insured Americans. Among all 20- to 44-year-olds, about one in 50 took ADHD medications in 2010 — 1.9 percent of women, and 1.8 percent of men, whose use increased more than 150 percent from 2001 to 2010.

One factor for the rise in adults taking ADHD drugs might be that all five medications indicated for treating the condition have been approved since 2001. Dr. Lenard Adler, director of the Psychiatry and Neurology Adult ADHD Program at the New York University School of Medicine feels that since these women could not have developed ADHD in adulthood, it's likely that women who started taking meds in the past decade flew under the radar until they became adults. That’s because girls are less likely than boys to exhibit the “H”—for hyperactivity—in ADHD, so boys with the condition are more likely to be noticed, says Adler, who was not involved with the Medco report. But as children grow into adulthood, he says, the “attention deficit” component of ADHD becomes more prominent, because grown-ups have a lot more to keep track of.

Adler explained that these girls whose ADHD had gone unrecognized and termed laziness or lack of motivation in school grow into women who stumble when they encounter the real world of work and family. They can’t hold jobs, and, because they are so disorganized, they pay their bills late, if at all, lose track of appointments and misplace their kids’ school permission slips.

Parenthood often leads to adults finally getting an ADHD diagnosis, Adler said. “Many times for a parent, what will bring them in to be diagnosed is they have a child who’s been diagnosed.” The parents might recognize that their child’s symptoms are ones they themselves have dealt with for years. When a child is diagnosed with ADHD, he said, there’s a 30 percent to 40 percent chance that a parent has it, too.

Of those parents, the moms are more likely to seek professional help than the dads, explains Russell Barkley, a clinical professor of psychiatry at the Medical University of South Carolina who’s long studied ADHD in adults. And in the last couple of years, Barkley says, there is probably heightened awareness.

Adler says he’s glad the data show more women are seeking treatment, but since 4.5 percent of adults are thought to have ADHD, it's clear that less than half are getting help. “There’s a large group out there still not being treated,” he warned though.

Use of other psychiatric medications

Further antidepressant use especially is high among women, up 29 percent since 2001, the report showed, and anti-anxiety meds are used by women at almost twice the rate seen among men. In 2010, 11 percent of middle-aged women were on an anti-anxiety medication, while only 5.7 percent of men that age were.

The use of atypical antipsychotics - medications once mainly prescribed for schizophrenia - have gone up dramatically as well. The number of adults ages 20 to 64 taking these meds is 3.5 times higher than it was 2001. And although the number of men on these drugs increased more dramatically during that time, there are still more women than men taking the medications.

Dr. David Muzina, a psychiatrist and national practice leader of the Medco Neuroscience Therapeutic Resource Center, explained to The Huffington Post that there is a rise in women patients mainly because it is known that “women tend to seek treatment and go to doctors' offices more frequently than men do. When you move into the behavioral health space, that may be even more true, so the opportunity to get evaluated and diagnosed and treated is likely higher.” Additionally he said, “We also believe that [women] may be at higher risk for major depressive disorders. It likely is biological. We don’t know exactly why. I can speak from experience as a practicing psychiatrist, comparing a general visit between a psychiatrist and a woman versus a male patient, that there is more resistance and reluctance from the men to be willing to accept treatment. There may be some subtle differences there with men thinking they need to tough it out.”

He added that, “Women are bearing the brunt of the emotional stressors around us: they're working, raising the kids, trying to juggle all these issues, getting all these things done, and they're more likely to reach out and ask for help.”

Explaining what this report implies for patients and doctors he said, “All drugs they come with risk. When I see numbers like this, with an increased trend, it emphasizes the importance that both patients and their doctors are aware of the risks of these medications. For example, with antidepressant medications in young adults, there is a risk early on of an increase in suicidal thoughts and perhaps suicidal behavior that clearly needs to be monitored very closely. The other example would be with the atypical antipsychotics, which have been associated with an increase in cholesterol. There's an association with Type 2 diabetes, and it can be a very rapid onset. Thinking about the overall health risks is crucial.”