ADHD Medication Reimbursements Quadruple in Ireland as Young Adults Drive Decade-Long Surge
New research published in the Irish Medical Journal has found that the number of patients receiving public reimbursements for ADHD medication in Ireland has increased by 314% over the past decade — rising from 3,377 to 13,966 individuals — with the largest growth concentrated among young adults aged 16 to 34 and dispensing rates for women now nearly equal to those of men, in findings that researchers say highlight a need for expanded assessment pathways and improved multidisciplinary follow-up.
Background
Attention Deficit Hyperactivity Disorder is a neurodevelopmental condition characterised by difficulties with attention, hyperactivity, and impulsivity. For many years, ADHD was primarily associated with children, and the majority of research and clinical practice focused on diagnosis and treatment in childhood. However, there has been a growing recognition over the past two decades that ADHD persists into adulthood for many individuals and that a significant proportion of adults with the condition were never diagnosed in childhood — either because the condition was not recognised, because they developed coping strategies that masked their difficulties, or because they were girls or women, who have historically been underdiagnosed.
The study analysed dispensing patterns for first-line stimulant medications — specifically methylphenidate and lisdexamfetamine — for individuals aged 16 and older through the General Medical Services and Drug Payment schemes of the Irish Primary Care Reimbursement Service. The data covers the period from 2015 to 2024 and provides the most comprehensive picture yet of the scale and trajectory of adult ADHD medication use in Ireland's public health system.
The findings are consistent with trends observed in other countries, where increased awareness of adult ADHD, improved diagnostic tools, and greater willingness among adults to seek assessment have driven significant increases in diagnosis and treatment rates. However, the scale of the increase in Ireland — 314% over a decade — is striking and raises important questions about the adequacy of the health system's capacity to meet the growing demand for assessment and treatment.
Key Developments
The study found that the total number of recorded dosage units of ADHD medications rose by 211% between 2015 and 2024, increasing from 700,574 to 2.2 million. The sharpest increase was in lisdexamfetamine, which saw a 504% rise in units dispensed between 2020 and 2023, reflecting both the growing recognition of its effectiveness and the expansion of prescribing to adult patients.
The largest absolute growth in patient numbers occurred among young adults aged 16 to 34, which grew from 2,708 to 7,930 patients over the decade. Significant increases were also observed in the 35-54 age bracket, while the 55 and over demographic remained the least prevalent but still showed steady growth. By 2024, dispensing rates for women had risen to levels nearly equal to those of men — a significant shift from the historical pattern in which ADHD was diagnosed and treated predominantly in males.
The research identified clear regional variations in access, with the most significant increases in patient counts observed in North Cork, Waterford, and Cork-South Lee. The authors suggested that these variations might reflect differing levels of access to diagnostic services, specialised pathways, and trained clinicians across different parts of the country — a finding that has implications for health service planning and for the equitable distribution of mental health resources.
Why It Matters
The surge in ADHD medication reimbursements matters because it reflects a genuine and significant change in the mental health landscape in Ireland. The increase is not simply a product of over-diagnosis or over-prescribing — it reflects the belated recognition that ADHD is a condition that affects a significant proportion of the adult population and that has been systematically underdiagnosed for decades, particularly in women and in those who developed coping strategies that allowed them to function despite their difficulties. The growing number of adults receiving treatment for ADHD is, in many respects, a positive development — it means that people who have struggled for years without understanding why are finally receiving the support they need.
However, the scale of the increase also raises important questions about the capacity of the health system to meet the growing demand for assessment and treatment. ADHD assessment in Ireland is currently concentrated in a relatively small number of specialist services, and waiting times for assessment can be extremely long — particularly in the public system. The regional variations identified in the study suggest that access to diagnosis and treatment is not equitable across the country, with some areas significantly better served than others.
Local Impact
The regional variations identified in the study have direct implications for health service planning in Ireland. The concentration of growth in North Cork, Waterford, and Cork-South Lee suggests that these areas have developed more accessible diagnostic pathways than other parts of the country, and that the experience of patients in these areas may be significantly better than that of patients in regions with fewer specialist services. The HSE has been under pressure to expand ADHD assessment capacity across the country, and the study's findings provide additional evidence for the need for investment in this area. For the thousands of adults across Ireland who are currently on waiting lists for ADHD assessment, the study's findings are a reminder that their experience is part of a much larger pattern of unmet need.
What's Next
The researchers have called for expanded assessment pathways, improved multidisciplinary follow-up, and structured medicines management to support the growing number of adults diagnosed with ADHD. The HSE is expected to respond to the study's findings as part of its ongoing review of mental health service capacity. The Department of Health has indicated that ADHD services will be a priority area in the next phase of the national mental health strategy. The study's authors have also called for the inclusion of private prescriptions in future research, noting that the figures they analysed are likely to represent a significant underestimate of total adult ADHD medication use in Ireland.
