Prescribing Patterns of Methylphenidate and Atomoxetine for Patients with Attention-Deficit/Hyperactivity Disorder

Purpose: To determine the prescribing pattern of methylphenidate and atomoxetine to patients with Attention-Deficit/Hyperactivity Disorder (ADHD) in South Africa.
Methods: A retrospective, cross-sectional pharmacoepidemiological study was conducted based on the data from a medical aid administrator in South Africa for 2011. All records for ADHD patients who received one or more prescriptions for methylphenidate and/or atomoxetine (ATC Code N06BA) were extracted for analysis.
Results: A total of 455 patients (mean age: 16.5 ± 11.56 yr) received 1653 prescriptions for methylphenidate and/or atomoxetine at a total cost of South African Rand 554,915.84 (US dollar 1.0 = Rand 6.76). A majority of these patients (70.34 %) were males and 21.10 % were older than 18 yr (25.76 % of females and 19.81 % of males). About a third of the prescriptions (30.44 %) were dispensed to children younger than 12 years while 25.88 % were dispensed to adolescents (12 to 18 years). Most prescriptions (92.01 %) were for methylphenidate while atomoxetine accounted for 7.99 % of the prescription. A majority of the prescriptions for methylphenidate (47.86 %) were for children younger than 12 yr, and most prescriptions for atomoxetine (52.27 %) were for adolescents.
Conclusion: Methylphenidate is the mainstay in the treatment of ADHD in South Africa, with atomoxetine prescribed more often to older patients. Drug use is rational and dosages are within the recommended dosage ranges. As expected, older patients are receiving treatment for ADHD.

Keywords
Methylphenidate; Atomoxetine; Attention-Deficit/Hyperactivity disorder; Pharmacoepidemiology