Exposures to attention deficient hyperactivity disorder medications reported to the New South Wales Poisons Information Centre (2014–2023): A retrospective study

Abstract

Objective:

To describe Australian trends in poisoning exposures to attention deficit hyperactivity disorder medication reported to the New South Wales Poisons Information Centre over a 10-year period.

Methods:

This is a large retrospective case series of human exposures to the following medications used for attention deficit hyperactivity disorder: atomoxetine, clonidine, dexamphetamine, guanfacine, lisdexamfetamine and methylphenidate. We extracted exposures from the New South Wales Poisons Information Centre database from 2014 to 2023. Exposures are reported per 100,000 population, data obtained from the Australian Bureau of Statistics. Dispensing data was obtained from the public Pharmaceutical Benefits Scheme Report.

Results:

There were 17,299 exposures reported to New South Wales Poisons Information Centre during this period. Exposure rates increased by 16.5% (95% confidence interval: 15-18%) annually. Groups with some of the greatest annual increases were female adolescents 20.4% (95% confidence interval: 16-25.4%) and children 18.5% (95% confidence interval: 14.7-22.8%). Over half of exposures (9657) were referred into hospital or were in hospital at the time of the call to New South Wales Poisons Information Centre. Sixty percent (10,427) of exposures were unintentional. There was a strong positive correlation between exposures and number of prescriptions, R² = 0.94, significant F = 4.5 × 10⁻⁶.

Conclusion:

Exposures to attention deficit hyperactivity disorder medications present a growing public health issue. Rates have risen annually over the past decade, and the majority require medical attention, placing strain on healthcare resources. There are notable differences in exposure patterns among affected age groups. This highlights the need for targeted preventive measures focused on both quality use of the medication being prescribed as well as considering the circumstances and safety of the individual and household.