Prevalence of methylphenidate use and change over a two-year period: A nationwide study of 2- to 11-year-old Canadian children

doi:10.1067/mpd.2002.125399

The Journal of Pediatrics

Volume 141, Issue 1, July 2002, Pages 71-75

https://doi.org/10.1067/mpd.2002.125399 Get rights and content

Abstract

Objective: To provide age- and sex-specific estimates of methylphenidate use and to determine use changes over a 2-year period. Study design: We examined the first and second data collection cycles of the National Longitudinal Survey of Children and Youth, a Canadian household survey of children. Participants were children aged 2 years to 11 years at both the first and second cycles whose mothers responded; thus, 16,798 (13,059) children were assessed for the first (second) cycle. Logit modeling was used to estimate prevalence of methylphenidate use, to determine sex and age effects on prevalence, and to examine use changes from cycle 1 to 2. Results: Methylphenidate prevalence ranged from 0.09% to 3.89% across 2- to 11-year old children from the first cycle. Boys were 4.6 times more likely than girls to consume methylphenidate. Use was >4 times greater among 6- to 7-year-old children compared with 4- to 5-year-old children and almost 2 times greater among 8- to 9-year-old children compared with 6- to 7-year-old children. Methylphenidate prevalence increased by 36% from cycle 1 to 2. Conclusions: Methylphenidate prevalence was relatively low. Boys and school-age children had higher rates of methylphenidate use, and use among 2- to 11-year-old children appeared to be increasing over time. (J Pediatr 2002;141:71-5)

Section snippets

Sample and procedure

The sample consisted of children from the National Longitudinal Survey of Children and Youth (NLSCY), a Canadian nationwide household survey that is being conducted by Human Resources Development Canada and Statistics Canada. The purpose of the survey is to follow into adulthood a representative sample of Canadian children aged newborn to 11 years, collecting information every 2 years. Households were chosen using a stratified multistage probability sample design on the basis of information

Age and sex effects on methylphenidate prevalence

The logit model examining the independent effects of a child's age and sex on the prevalence of methylphenidate use in 1994 and 1995 showed an acceptable fit (L² = 3.71, P =.45; χ² = 4.26, P =.37; degrees of freedom = 4). Methylphenidate prevalence estimates for girls and boys across the 5 age groups are displayed in the Figure.

Figure. Methylphenidate prevalence estimates (%) from the first NLSCY data collection cycle.

Overall, methylphenidate use was low, ranging from 0.09% to 0.87% for girls

Discussion

Our findings indicate that methylphenidate prevalence was relatively low and ranged from 0.09% to 3.89% across 2- to 11-year-old children. Methylphenidate use was such an infrequent occurrence in girls and in children <5 years old that our nationwide prevalence rates for these children had limited accuracy. Methylphenidate use was >4 times greater for boys than girls across all age groups, a finding similar to that from past Canadian and US studies.4, 6, 8, 10 Methylphenidate use was >4 times

Acknowledgements

We thank Pierre McDuff for data management and Dr Michel Vanasse for helpful comments on an earlier version of this paper.

References (19)

LL Greenhill et al.
Stimulant medications
J Am Acad Child Adolesc Psychiatry
(1999)
RD Stevenson et al.
Stimulant medication therapy in the treatment of children with attention deficit hyperactivity disorder
Pediatr Clin North Am
(1989)
PS Jensen et al.
Psychoactive medication prescribing practices for US children: gaps between research and clinical practice
J Am Acad Child Adolesc Psychiatry
(1999)
K McBurnett et al.
Experimental cross-validation of DSM-IV types of attention-deficit/hyperactivity disorder
J Am Acad Child Adolesc Psychiatry
(1999)
Intercontinental medical statistics
The Canadian Disease and Therapeutic Index
Personal communication
(2000)
MD Brownell et al.
Attention-deficit hyperactivity disorder in Manitoba children: medical diagnosis and psychostimulant treatment rates
Can J Psychiatry
(2001)
LM Robison et al.
National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990-1995
Clin Pediatr
(1999)
JM Zito et al.
Trends in the prescribing of psychotropic medications to preschoolers
JAMA
(2000)
JM Zito et al.
Prevalence variations in psychotropic treatment of children
J Child Adolesc Psychopharmacol
(1998)

There are more references available in the full text version of this article.

Cited by (21)

Reproductive parameters of female Wistar rats treated with methylphenidate during development
2016, Physiology and Behavior
Citation Excerpt :
Several studies have shown that the prevalence of ADHD is higher in boys than in girls [10,11]. However, longitudinal studies in school-aged children have indicated an increase in the proportion of girls using MPH [1,2,12], which raises major concerns for public health due to possible persistent neurobehavioral changes [13–15]. In mammalians, important changes in the brain architecture and plasticity occur in the period from immediately before birth until adolescence and these changes could be influenced by exposure to psychotropic stimulant drugs [16–18].
Methylphenidate (MPH), a psychoactive agent that acts mainly by blocking the uptake of dopamine, is the main drug used to treat Attention Deficit Hyperactivity Disorder in children and adolescents. During development, important changes in brain architecture and plasticity occur, these changes, sensitive to exposure to stimulant drugs, are important in the control of GnRH secretion, influencing the release of sex hormones throughout the ovarian cycle. This study investigated the effects of repeated treatment with MPH during development on reproductive parameters of adult female rats. Wistar rats received MPH 2.5 mg/kg, MPH 5.0 mg/kg, or tap water (gavage) from postnatal day (PND) 21 to PND 60. From PND 75, one subgroup of females was selected for evaluation of estrous cycle, estradiol levels, weight of sexual organs, and histomorphological analysis of ovary follicles and uterus. In another subgroup, the sexual and maternal behaviors were evaluated at PND 90 and on lactational day 5, respectively. No significant alterations were observed in the MPH groups. This study demonstrated that repeated administration of MPH during the period corresponding to childhood to early adulthood does not interfere in the reproductive function of female rats in adulthood.
An 8-Year Follow-up Study of Profiles and Predictors of Methylphenidate Use in a Nationwide Sample of Boys
2009, Journal of Pediatrics
Citation Excerpt :
The current study used data from 5 cycles (1994 to 2002), selecting boys who were 2 to 3 years old at cycle 1 and who were followed longitudinally over the 5 cycles (n = 1531). We focused on boys because earlier results indicated minimal methylphenidate use among 2- to 11-year-old girls.4 We only examined methylphenidate because the NLSCY does not inquire about other psychostimulants.
To identify methylphenidate profiles over several years in a national sample of boys and examine behavioral and sociodemographic predictors of use.
Five cycles of a Canadian survey were used, resulting in 1447 boys followed from 2 to 3 years to 10 to 11 years. Mother reports of boys' methylphenidate use from 4 to 5 years to 10 to 11 years were used to identify profiles over time. Mother-reported sociodemographic and child behavior data at 2 to 3 years were then used to predict methylphenidate profiles.
Three methylphenidate profiles were identified: no use (87.2%); slow-rising, intermittent (11.2%); and fast-rising, stable (1.6%). Sociodemographic variables were not significant predictors. Boys with greater hyperactivity-impulsivity, greater inattention, and less disruptive behavior were more likely to belong to the fast-rising, stable methylphenidate profile. Although 13% of boys were using methylphenidate over time, there were 2 heterogeneous profiles. In the first profile, there were very few initial users followed by a steady increase in the number of boys using methylphenidate over time. Among these boys, however, use was inconsistent over time. In the second profile, there was a sharp onset of methylphenidate use on school entry, followed by consistent use thereafter.
These findings have implications for the treatment effectiveness of attention deficit–hyperactivity disorder symptoms. It is important to continue examining the role of disruptive behavior because its co-occurrence with attention deficit–hyperactivity disorder symptoms and methylphenidate use is complex.
Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents A Systematic Scoping Review
2021, JAMA Network Open
Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: Results from a population-based study
2014, Journal of Developmental and Behavioral Pediatrics
Prevalence of prescribed attention-deficit hyperactivity disorder medications and diagnosis among canadian preschoolers and school-age children: 1994-2007
2012, Canadian Journal of Psychiatry
Reinforcing and subjective effects of methylphenidate in adults with and without attention deficit hyperactivity disorder (ADHD)
2009, Psychopharmacology

View all citing articles on Scopus

^☆: Supported by the Applied Research Branch of Human Resources Development Canada (grant No. 9137-99-0080), a research grant from Quebec's Fonds pour la Formation de Chercheurs et l'Aide à la Recherche (FCAR) funding agency (to E. R.), and a Québec Relève Médecine 2000 research grant (to R. H. B.).

^☆☆: Reprint requests: Elisa Romano, PhD, Research Unit on Children's Psychosocial Maladjustment, University of Montreal, CP 6128, succursale Centre-ville, Montreal, Québec, Canada H3C 3J7.

View full text

Original ArticlesPrevalence of methylphenidate use and change over a two-year period: A nationwide study of 2- to 11-year-old Canadian children☆,☆☆

Abstract

Section snippets

Sample and procedure

Age and sex effects on methylphenidate prevalence

Discussion

Acknowledgements

J Am Acad Child Adolesc Psychiatry

Pediatr Clin North Am

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

The Canadian Disease and Therapeutic Index

Personal communication

Attention-deficit hyperactivity disorder in Manitoba children: medical diagnosis and psychostimulant treatment rates

Can J Psychiatry

National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990-1995

Clin Pediatr

Trends in the prescribing of psychotropic medications to preschoolers

JAMA

Prevalence variations in psychotropic treatment of children

J Child Adolesc Psychopharmacol

Original Articles
Prevalence of methylphenidate use and change over a two-year period: A nationwide study of 2- to 11-year-old Canadian children☆,☆☆