Is this why the US Adderall crisis is spiraling out of control? Doctors prescribe stimulants in addition to antidepressants to combat sluggishness, research shows
Doctors prescribe stimulants in addition to antidepressants to combat sluggishness, research shows.
Many adults are given drugs such as amphetamines, which carry a high risk of abuse, as well as treatments for anxiety and depression.
Prescriptions for stimulants like Adderall are on the rise in America, and a survey last week found that one in four American teens abuse prescription stimulants in some schools.
The Drug Enforcement Administration categorizes amphetamines and methylphenidate as Schedule II controlled substances – the same classification as cocaine, OxyContin and fentanyl.
Prescriptions for Adderall surged during the Covid-19 pandemic. In February 2020, just before the virus broke out across America, the drug made up 1.1 percent of prescription drugs. By September 2022, the figure had more than doubled to 2.31 percent of all scripts written
Doctors often prescribe stimulants to combat the side effects of other drugs to treat anxiety and depression, or to amplify the drug’s impact
Amphetamines such as Adderall, the most commonly prescribed stimulant, strengthen the body’s nervous system and are prescribed for a range of conditions, for example attention deficit hyperactivity disorder (ADHD), sleep disorders and nasal congestion.
But they can also be prescribed off-label — where medication is given for purposes other than what it was originally approved for — for depression and anxiety in combination with other medications.
Doctors often prescribe stimulants to combat the side effects of other drugs or to enhance the effects of the drug.
The study’s lead author, Thomas Moore, a researcher at the Center for Drug Safety and Effectiveness at Johns Hopkins University, told NBC news this was known as a ‘prescribing cascade’.
Graph showing the percentage of the 9,141,877 patients in the study who took different combinations of medications. Combination-2, the blue columns, refers to stimulant drugs in combination with one or more psychiatric drugs. Combination-3, the orange columns, refers to stimulants mixed with two or more psychiatric drugs
He said: ‘A patient is prescribed an antidepressant and maybe one of the side effects is sedation, so they add a stimulant like amphetamines.
“Or maybe the drug has fairly modest effects, and if they add an amphetamine to it, they get a bit more of a kick.”
From October 2019 to December 2020, researchers from Johns Hopkins University Bloomberg School of Public Health, Baltimore and The George Washington University, DC, looked at insurance claims from more than 9.1 million adults with private health insurance.
Prescription drugs counted as adults who received one or more stimulant drugs containing amphetamines and methylphenidate, the active ingredient of Ritalin.
Published Monday in the BMJ openedthe researchers found that more than 276,000 adults used schedule II prescription stimulants.
Just under half (about 45 percent) took the drugs along with other drugs such as antidepressants, anti-anxiety drugs and opioids.
Mr Moore said: ‘We are concerned about the risks of these drugs.’
He added that prescription stimulants are “very potent” and have “great potential for physical and psychological dependence.”
Mr Moore said the research on prescription stimulants mixed with other psychiatric drugs is sparse.
He also said that the number of stimulants and other drugs taken is increasing, but the study did not look at changes over time.