The proportion of people in the UK on attention deficit hyperactivity disorder (ADHD) medication has tripled in the past decade, with a 20-fold increase among women aged 25 and over, a study shows.

Researchers led by the University of Oxford examined electronic health records from Belgium, Germany, the Netherlands, Spain and the UK to estimate the use of ADHD medication among adults and children aged three and above.

Prevalence increased across all five countries between 2010 and 2023, according to the research. The UK had the highest relative increase for all ages, rising more than threefold from 0.12% to 0.39%. In the Netherlands, prevalence more than doubled, from 0.67% to 1.56%.

The results of the study, which tracked methylphenidate, dexamphetamine, lisdexamfetamine, atomoxetine and guanfacine, was published in the Lancet Regional Health – Europe journal.

Adult use increased substantially in all countries, particularly among women. In the UK, prevalence among people aged 25 and over increased from 0.01% in 2010 to 0.20% in 2023, with a more than 20-fold increase in women and 15-fold in men.

Although ADHD medication use remained higher among males, the sex gap in treatment narrowed over time and with increasing age, the researchers said.

“We observed a consistent increase in ADHD medication use across Europe, but the most striking changes were among adults, especially women,” said Xintong Li, the lead study author at Oxford. “These findings likely reflect growing awareness and diagnosis of adult ADHD, but they also raise important questions about long-term treatment patterns and care needs.”

The results also suggested a much lower rate of ADHD medication use compared with the estimated rate of ADHD itself, which is thought to affect about 8% of children and adolescents and 3% of adults globally, the researchers said.

They said while it was true that not everyone with ADHD required medication, the findings suggested a substantial proportion may not be doing so.

Methylphenidate was the most commonly used medication across all countries. Newer treatments such as lisdexamfetamine and guanfacine showed steady uptake after market approval. However, continuation of treatment after initiation was relatively low, varying substantially between countries.

The findings reflected growing recognition of ADHD as a lifelong condition and highlighted the need for healthcare systems to plan for rising demand, particularly amid ongoing ADHD medication shortages in parts of Europe, the researchers said.

In the UK, the NHS is overspending by £164m a year on ADHD services, with an increasing amount going to unregulated private assessments, the Guardian reported earlier this month.

Analysis showed that total spending on NHS ADHD services was expected to be more than double existing budgets. Further data showed the amount spent on private ADHD services had more than tripled over three years.

Prof Daniel Prieto-Alhambra, a senior author of the study, said: “Understanding how ADHD medications are being used in real-world clinical practice is essential for healthcare planning. These data can help health systems anticipate demand and reduce the risk of future medication shortages, while also highlighting populations that may need closer monitoring.”