# Global Trends in ADHD Medication Use: Multiple Contexts and Rising Concerns—A Narrative Review

## TL;DR

ADHD medication use has increased globally since 2000, with variations in drug preferences and gender trends, raising concerns about access and misuse.

## Contribution

This review provides a comprehensive analysis of ADHD medication trends across multiple countries and highlights gender and drug usage shifts.

## Key findings

- ADHD medication use increased globally since 2000, except in the Netherlands.
- Methylphenidate remains the most prescribed drug, but lisdexamfetamine and guanfacine use is rising.
- Gender ratios for ADHD medication use shifted, with faster increases among females in adulthood.

## Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition frequently treated with pharmacological interventions, most commonly stimulants such as methylphenidate and amphetamines, alongside non-stimulant options. This narrative review, based on 31 publications and five national drug utilization registers, summarizes global trends in ADHD medication use since 2000. Across most countries, prevalence of ADHD medication use increased steadily, with the sole exception of the Netherlands, where recent declines were observed. The highest prevalence of ADHD medication use was consistently found among older children and adolescents. While boys showed higher values of prevalence of ADHD medication use than girls in childhood, faster increases among females resulted in reversed gender ratios in several adult populations. Methylphenidate remained the most widely prescribed drug, although the use of lisdexamfetamine and guanfacine has expanded in recent years. Variations in national guidelines, diagnostic frameworks, healthcare access, and sociocultural acceptance of pharmacotherapy contributed to observed differences across regions. Increasing use of ADHD medications raises important questions about equitable access to treatment, potential overdiagnosis, and the risk of stimulant misuse. These findings highlight the need for continued monitoring of utilization patterns to ensure safe, rational, and equitable ADHD care worldwide.