Behavior Health Medications Increase During COVID-19 Pandemic

The use of behavioral health medications during the COVID-19 pandemic in the US remained stable overall, but there was a significant increase in the use of ADHD medications, according to a study published in JAMA Psychiatry.

“This was a cross-sectional study using comprehensive, population-level, nationally projected data from IQVIA National Prescription Audit on incident prescriptions (prescriptions dispensed to patients with no prior dispensing from the same drug class in the previous 12 months) dispensed for antidepressants, benzodiazepines, Schedule II (C-II) stimulants, non-stimulant medications for ADHD, and buprenorphine-containing medication for OUD (MOUD), from US outpatient pharmacies,” wrote Grace Chai, PharmD, MPH, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland.

During the COVID-19 pandemic, there was a shift in prescription patterns for 5 drug classes when compared with the prepandemic period. Incident prescriptions rose for antidepressants by 10% (from approximately 29.2 million to 32.1 million), C-II stimulants by 14% (from about 5.2 million to 5.9 million), and non-stimulant ADHD medications by 32% (from around 1 million to 1.35 million). In contrast, benzodiazepines saw a 9% decrease (from approximately 15.1 million to 13.7 million), and buprenorphine used in medication for opioid use disorder (MOUD) decreased by 2% (from around 927,000 to 908,000).

The distribution changes between the pre-pandemic and pandemic periods were most pronounced among nurse practitioners, who showed an increase in incident prescription writing across all drug classes, with changes ranging from 7% for benzodiazepines (from about 1.8 million to 1.9 million) to 78% for buprenorphine MOUD (from around 158,000 to 281,000). When looking at patient age and sex, the most significant shifts within drug classes were observed for C-II stimulants and nonstimulant ADHD drugs. There was a 30% increase for patients aged 20-39 years (from about 1.9 million to 2.46 million) and an 81% increase (from around 255,000 to 461,000), with female patients showing increases of 25% (from about 2.35 million to 2.94 million) and 59% (from around 396,000 to 631,000), respectively, for these medications. “The differential changes during the pandemic in incident prescription trends for ADHD medications, particularly for C-II stimulants, underscore the need for robust policies to address unmet needs while balancing public health concerns,” wrote the study authors.

Reference

Chai G, Xu J, Goyal S, et al. Trends in incident prescriptions for behavioral health medications in the US, 2018-2022. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2023.5045