People with attention-deficit/hyperactivity disorder (ADHD) who begin taking medications for the condition within three months of their diagnosis may have a lower risk of dying within two years compared with their peers who do not take ADHD medications, a study in JAMA has found.
Zheng Chang, Ph.D., of the Karolinska Institutet in Stockholm and colleagues examined data from 148,578 Swedish individuals aged 6 to 64 years who had an incident diagnosis of ADHD from 2007 through 2018 and no ADHD medication dispensation for at least 18 months prior to their diagnosis. They followed the patients from ADHD diagnosis for two years or until death, emigration, or December 31, 2020, whichever came first. The researchers categorized mortality into natural causes (that is, physical conditions) and unnatural causes (that is, suicide, accidental injuries, accidental poisoning, and other external injuries).
Overall, 56.7% of the patients initiated ADHD medication. This was defined as receiving any of the six licensed ADHD medications (methylphenidate, amphetamine, dexamphetamine, lisdexamfetamine, atomoxetine, and guanfacine) within three months of diagnosis.
The researchers found that patients who initiated ADHD medication had a 21% lower risk of dying of any cause and a 25% lower risk of dying from unnatural causes compared with patients who did not initiate ADHD medication.
“ADHD medication may reduce the risk of unnatural-cause mortality by alleviating the core symptoms of ADHD and its psychiatric comorbidities, leading to improved impulse control and decision-making, ultimately reducing the occurrence of fatal events,” Chang and colleagues wrote. “There is also evidence showing that ADHD medications were associated with lower risk of accidents, substance use, and criminality, which in turn could lead to lower rates of unnatural deaths.”
There was no statistically significant difference in death by natural causes between the two groups. The researchers said that this was reassuring given concerns about the cardiovascular safety of stimulants.
The researchers added that their results cannot conclusively establish a cause-and-effect relationship between initiating ADHD medications and lower risk of dying because they did not measure certain confounders, such as lifestyle factors, that could affect risk.
For related information, see the Psychiatric News article “ADHD Meds Linked to Cardiovascular Risk.”
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