The number of prescriptions being issued in England for attention deficit hyperactivity disorder (ADHD) medication has risen by 18% year-on-year since the pandemic, with experts saying increased public awareness via social media platforms could be a factor encouraging more people to seek treatment.
In their study, academics from the University of Huddersfield and Aston University found that the number of ADHD prescriptions in England increased from around 25 per 1 000 people in 2019/20, to 41.55 prescriptions in 2023/24, an average annual increase of 18%.
Their findings were published in BMJ Mental Health.
However, Dr Paul Keedwell, a consultant psychiatrist and neurodiversity specialist, warned that over-diagnosing ADHD could be a factor behind the rise in prescriptions seen in this study.
Regional differences
The team looked at English prescribing data for the five currently licensed ADHD drugs at national, regional, and NHS integrated care board (ICB) levels.
They found that methylphenidate (with brand names like Ritalin, Concerta and Delmosart) remained the most frequently prescribed drug (19 items/1000 people), but the highest increase was for lisdexamfetamine, prescriptions for which increased by 55% year-on-year, rising from 2.86 items/1000 people in 2019-20 to 8.68 items in 2023-24.
The study also showed regional differences across England regarding prescription rates. Although scripts rose across all regions, London saw the highest annual increase of 28%, south-east England saw the second highest increase at 19.5%, and the north-east and Yorkshire had the lowest increase at 13%.
The analysis also found a strong association between factors such as ethnicity and deprivation and ADHD prescription rates. The researchers said that south-east England and north-west England, which have significant white populations, show higher prescription counts overall compared with more ethnically diverse regions like the Midlands and London.
The researchers said that “widespread disruption and increased psychological stress levels” could be a factor contributing to the rise in prescriptions. They added that their findings reveal that the increase in prescriptions is higher than reported in previous studies.
“The findings of this study have significant implications for health policy and clinical practice. The significant rise in ADHD prescriptions across England highlights the urgent need for policies that address both regional and socioeconomic disparities in ADHD care access. The finding that more people are receiving ADHD treatment is encouraging, particularly given reports of long waiting times between A referral and assessment, as well as variations across different regions.”
The team called for more research on vetting and moderating ADHD-related information on social media to ensure awareness efforts “do not inadvertently spread misinformation”.
“Additionally, the role of professional diagnosis and treatment should be emphasised, balancing the role of social media with evidence-based practices,” they said.
Keedwell cautioned that there could be a degree of over-diagnosing.
“Although there is no clear evidence for this, it is important that all individuals receive a holistic assessment with a psychiatrist. Many other mental health conditions can cause ADHD-like symptoms. For example, my own clinical work has revealed many cases where inattention problems were caused by untreated depression rather than ADHD.
“Also, ADHD is often accompanied by other mental disorders like autistic spectrum disorder, complex trauma, anxiety and depression.
“Concerning demographic trends, lower engagement with assessment and treatment among minorities and poorer communities is nothing new and not confined to ADHD. There could be differences in the availability of ADHD services across the country, so more research is required.”
Study details
Socioeconomic status and prescribing of ADHD medications: a study of ICB-level data in England
Muhammad Umair Khan, Syed Shahzad Hasan.
Published in BMJ Mental Health on 11 March 2025
Abstract
Background Little is known about the impact of healthcare structural changes and socioeconomic indices, such as deprivation, mental health needs, and inequalities, on attention-deficit hyperactivity disorder (ADHD) medication prescribing across different regions in England.
Objective
The objective was to examine trends in ADHD medication prescribing and explore their association with socioeconomic factors.
Methods
A population-level observational study was conducted using the English Prescribing Dataset (from April 2019 to March 2024) published by the NHS Business Services Authority and the OpenPrescribing platform (Bennett Institute for Applied Data Science, University of Oxford). The study examined trends in five licensed ADHD medications at national, regional and integrated care board (ICB) levels, using linear regression and a generalised additive model to explore the association between socioeconomic factors and prescription rates.
Findings
The prescriptions increased significantly from 25.17 items per 1000 population in 2019/20 (pre-COVID-19) to 41.55 items in 2023/24 (post-COVID-19), with an average annual increase of 18% nationally. Methylphenidate remained the most prescribed medication, while lisdexamfetamine showed the highest growth rate (55% annually, 95% CI 40% to 71%, p<0.01). Significant regional variations were observed, with London experiencing the highest annual increase (28%), and the Northeast and Yorkshire the lowest (13%). Socioeconomic factors, including ethnicity and deprivation, were significantly associated with ADHD prescription rates (p<0.05).
Conclusions
Findings reveal a substantial increase in ADHD medication use in England following the COVID-19 pandemic, with significant variations at regional and ICB levels and complex socioeconomic influences.
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