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Somnolence-Producing Agents: A 5-Year Study of Prescribing for Medicaid-Insured Children With Attention Deficit Hyperactivity Disorder.

Authors
  • Klein, Tracy
  • Woo, Teri M
  • Panther, Shannon
  • Odom-Maryon, Tamara
  • Daratha, Kenn
Type
Published Article
Journal
Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
Publication Date
Jan 01, 2019
Volume
33
Issue
3
Identifiers
DOI: 10.1016/j.pedhc.2018.10.002
PMID: 30630642
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Researchers evaluated the prescribing of medications that induce somnolence to children with attention deficit hyperactivity disorder (ADHD) insured by Medicaid. An observational study of prescription claims for children ages 3-18 with ADHD-associated ICD 9 diagnoses filled between January 1, 2012 and December 31, 2016 in Oregon. There were 14,567 prescriptions written for a 30-day supply of sleep medication for 2,518 children. Most were written for males (66.3%) and to those ages 12-18 (63.8%). Trazodone, hydroxyzine, quetiapine, clonazepam, and amitriptyline were frequently prescribed. There were few prescriptions for zaleplon and zolpidem. Trazodone, hydroxyzine, and amitriptyline are commonly prescribed without clinical efficacy or guidance for children with ADHD. Quetiapine is prescribed off label in sub-therapeutic doses for its somnolence effect. Mental health drugs, which have voluntary formulary guidance in Oregon, and antihistamines on formulary, are more frequently prescribed for children with ADHD than drugs with FDA approval for insomnia. Copyright © 2018 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

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