The shocking side effect of ADHD drugs that could impact 22million Americans
ADHD affects around five percent of children and 2.5 percent of adults globally, roughly 200 million people.
It is linked to increased risks of suicidal behaviors, substance abuse, accidental injuries, transport accidents and criminality if people do not seek treatment.
An international team of researchers wanted to establish if medication reduces these risks.
Researchers from the University of Southampton and the Karolinska Institute in Sweden found that for two years of treatment with ADHD medication, people who took the drugs were less likely to experience these harmful incidents than those who didn't take medication.
Around 22 million Americans are estimated to have ADHD and just over half of these are prescribed medication to manage their symptoms, which can include impulsiveness, disorganization and difficulty focusing.
Medications are broadly classified into two main categories: stimulants and non-stimulants. Stimulants, the most common type, include methylphenidate and amphetamine-based medications that improve the transmission of the brain chemical dopamine which affects mood, motivation and movement.
Non-stimulant options like atomoxetine, clonidine, and guanfacine can also be used, if stimulants are not effective or well tolerated. These help improve the transmission of norepinephrine, a hormone that helps with alertness and focus.
Some of the best known brand names for ADHD medications include Adderall, Ritalin, Vyvanse, Focalin, Concerta, and Daytrana.
Exactly why the condition occurs is not completely understood, but ADHD tends to run in families, suggesting genes may play a part.
It is surprisingly common and as diagnosis has risen, so too have prescriptions for ADHD medication.
From 2012 to 2022, the number of annual stimulant prescriptions increased by 57.9 percent, reaching 79.6 million, according to the DEA.
In the new study, researchers examined multiple population and health records in Sweden linked by unique personal identification numbers assigned to every resident in the country.
The team used a novel study design called a 'trial emulation' to simulate a trial using existing real-world data from 148,581 people with ADHD.
Comparing those who had started any type of ADHD medication within three months of diagnosis with those who hadn't, they examined the records over the following two years.
They found any form of medication reduced the first occurrence of four of the five incidents (with accidental injury being the exception) and all five outcomes when considering recurring incidents.
Those taking stimulant medication were associated with the lowest incident rates, compared to non-stimulant medications.
Methylphenidate was the most commonly prescribed drug, the researchers found.
The likelihood was most reduced amongst people exhibiting a recurring pattern of behavior, such as multiple suicide attempts, numerous drug relapses or repeat offending.
Medication didn't reduce the risk of a first-time accidental injury, but did reduce the risk of recurring ones.
The study is the first of its kind to show the beneficial effect of ADHD medication on these broader clinical outcomes using a novel statistical method and data representative of all patients in routine clinical care from a whole country.
'This finding is consistent with most guidelines that generally recommend stimulants as the first-line treatment, followed by non-stimulants,' explains Dr Zheng Chang, senior author of the study from the Karolinska Institute.
'There is an ongoing discussion regarding whether methylphenidate [a stimulant medication for ADHD] should be included in the World Health Organization model list of essential medications, and we hope this research will help to inform this debate.'
Co-senior author on the paper Samuele Cortese, a National Institute for Health and Care Research (NIHR) Research Professor at the University of Southampton added: 'The failure form clinical services to provide timely treatments that reduce these important outcomes represents a major ethical issue that needs to be addressed with urgency, with the crucial input of people with lived experience.'
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