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Prescription Patterns and Safety Monitoring Practices in Medication for Youths with Attention-defi cit/Hyperactivity Disorder

Chia-Ming Wu, Shu-Wen Cheng, Chih-Tsai Chen, Yuan-Chang Hsu, Cheng-Hsien Sung, Shih-Kai Liu, Kuo-Ping Li

Objective: As the use of methylphenidate and atomoxetine in youths with Attention-defi cit/hyperactivity disorder (ADHD) is increasing, medication safety is important. We intended to study the prescription patterns and safety monitoring practices of pharmacological treatment in ADHD youths. Methods: We enrolled patients who were younger than 18 years with the diagnosis of ADHD, visited our clinics, and had been prescribed immediate-release formulation of methylphenidate (IR-MPH), osmotic release oral system formulation of methylphenidate (OROS-MPH) or atomoxetine from January 1, 2013 to December 31, 2013. We sampled 100 persons in each IR-MPH and OROS-MPH groups and included all 35 patients in atomoxetine group due to limited numbers. Both electronic medical records and chart review were done to evaluate the characteristics of patients, to monitor adverse effects and the effi cacy of treatment in clinical practice. Results: Totally, 84.7% of these 235 persons were male; the mean age (11.3 ± 2.6 years) was signifi cantly lower in IR-MPH group. The rates of monitoring the adverse effect of the neuropsychiatric system, cardiovascular system, growth, body weight and appetite during medication ranged from 6% to 27%. No signifi cant difference noted in EKG check, chart record of monitoring for adverse drug reactions, and drug interaction among three groups; a signifi cant higher rate of effi cacy reported in IR-MPH and OROS-MPH groups. Conclusion: Based on this of study fi nding, we suggest that we need to enhance the monitoring of cardiovascular condition, neuropsychiatric side effects, growth, body weight and appetite during treatment for patients with ADHD.
Key Word attention-defi cit/hyperactivity disorder (ADHD), youths, prescription pattern, medication safety
Editorial Committe, Taiwanese Journal of Psychiatry
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