Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Morten Andersen, Department of Drug Design and Pharmacology, University of Copenhagen
- Second opponent: Associate Professor Marit Waaseth, Pharmacoepidemiology and social pharmacy, The Arctic University of Norway
- Third member and chair of the evaluation committee: Professor Jørund Straand, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor II Henrik Holmstrøm, Faculty of Medicine, University of Oslo
Principal Supervisor
Senior Researcher Jørgen G. Bramness, Norwegian Institute of Public Health, Nasjonal kompetansetjeneste for samtidig rusmisbruk og psykisk lidelse
Summary
Many Norwegian infants and toddlers receive the hypnotic drug alimemazine (Vallergan©), a first-generation antihistamine not approved for the age group nor recommended in paediatric guidelines. Even if mostly unproblematic and often perceived as effective, alimemazine has an uncertain effect on sleep in small children and is known for adverse effects such as sleepiness and dizziness the day after.
This thesis studied the use of hypnotic drugs, especially alimemazine, in children 0-3 years of age in Norway. We described the use of hypnotics, investigated whether it was related to parental characteristics and looked at an association between hypnotic drugs and a later Attention Deficit and Hyperactivity Disorder (ADHD) diagnosis.
The data shows that children of parents who had used hypnotic drugs or antidepressants before were more likely to have filled a prescription for alimemazine. Smoking among mothers, lower education, not being firstborn or having other illnesses were also related to being dispensed the drug. Also, children who received alimemazine were more likely to be diagnosed with ADHD when they reached primary school age, a risk not explained by other risk factors such as ADHD in the family. Among girls who had received alimemazine twice or more, there was a threefold increase in the risk. For boys, the risk doubled. It is unlikely that use of alimemazine as such causes ADHD but using the drug might be a proxy for infant sleep problems. The results of this study may indicate that children with early sleep difficulties have a higher risk of developing ADHD.
This pharmacoepidemiological study uses data from different Norwegian health registries; The Norwegian Prescription Data Base, The Norwegian Medical Birth Registry, The Norwegian Patient Registry, in addition to The Norwegian Mother, Father and Child Cohort Study (Norwegian Institute of Public Health) and Statistics Norway.
Additional information
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