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Marsha D. Rappley, MD; Joseph C. Gardiner, PhD; James R. Jetton; Richard T. Houang, PhD

Arch Pediatr Adolesc Med. 1995;149(6):675-679.

Abstract
Objective
To describe the epidemiologic findings associated with the use of methylphenidate hydrochloride among children aged 0 to 19 years in Michigan.

Design
A population-based data set of all prescriptions filed with the Michigan Triplicate Prescription Program during February and March 1992 was analyzed, maintaining complete anonymity.

Setting
State of Michigan.

Participants
All patients receiving a prescription for methylphenidate who are residents of Michigan, and all physicians prescribing methylphenidate.

Interventions
None.

Main Outcome Measures
Descriptive data.

Results
Eleven of 1000 Michigan residents between the ages of 0 and 19 years received a prescription for methylphenidate during the study period. Eighty-four percent were boys. Boys aged 10 or 11 years received more prescriptions for methylphenidate than any other age group—43 per 1000. The number of children receiving prescriptions for methylphenidate ranged from 2.5 to 28 per 1000. The range for boys aged 10 or 11 years was from 9.6 to 117 per 1000. Primary care physicians wrote 84% of all prescriptions; pediatricians wrote 59% of the prescriptions for patients younger than 20 years old. Half of the prescriptions written by pediatricians were written by 5% of the pediatricians in the state.

Conclusions
Michigan has been among the states with the highest per capita consumption of methylphenidate for the past 10 years. The major use of methylphenidate is for treatment of attention deficit hyperactivity disorder. The number of boys in Michigan aged 10 or 11 years who were treated with methylphenidate was similar to the national prevalence of the disorder, 3% to 5%. A tenfold variation was noted in the percentage of children medicated when the data were analyzed by county. Relatively few pediatricians account for the largest proportion of prescriptions. Future studies are needed to link the use of methylphenidate with diagnostic and treatment considerations in attention deficit hyperactivity disorder.

(Arch Pediatr Adolesc Med. 1995;149:675-679)

Author Affiliations
From the Department of Pediatrics and Human Development (Dr Rappley) and Program in Epidemiology (Dr Gardiner and Mr Jetton), College of Human Medicine, and Department of Counseling, Educational Psychology, and Special Education, College of Education (Dr Houang), Michigan State University, East Lansing.

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