Klein T, Woo TM, Panther S, Odom-Maryon T, Daratha K. Somnolence-Producing Agents: A 5-Year Study of Prescribing for Medicaid-Insured Children With Attention Deficit Hyperactivity Disorder.
J Pediatr Health Care 2019;
33:e1-e8. [PMID:
30630642 DOI:
10.1016/j.pedhc.2018.10.002]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/08/2018] [Accepted: 10/12/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION
Researchers evaluated the prescribing of medications that induce somnolence to children with attention deficit hyperactivity disorder (ADHD) insured by Medicaid.
METHOD
An observational study of prescription claims for children ages 3-18 with ADHD-associated ICD 9 diagnoses filled between January 1, 2012 and December 31, 2016 in Oregon.
RESULTS
There were 14,567 prescriptions written for a 30-day supply of sleep medication for 2,518 children. Most were written for males (66.3%) and to those ages 12-18 (63.8%). Trazodone, hydroxyzine, quetiapine, clonazepam, and amitriptyline were frequently prescribed. There were few prescriptions for zaleplon and zolpidem.
DISCUSSION
Trazodone, hydroxyzine, and amitriptyline are commonly prescribed without clinical efficacy or guidance for children with ADHD. Quetiapine is prescribed off label in sub-therapeutic doses for its somnolence effect. Mental health drugs, which have voluntary formulary guidance in Oregon, and antihistamines on formulary, are more frequently prescribed for children with ADHD than drugs with FDA approval for insomnia.
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