Light
Trending ADHD Papers
Light
Visual Abstract
ADHD Pharmacotherapy and Mortality in Individuals With ADHD
ADHD Medication and Mortality
December 9, 2024
author
Li L, Zhu N, Zhang L, Kuja-Halkola R, D'Onofrio BM, Brikell I, Lichtenstein P, Cortese S, Larsson H, Chang Z
journal
JAMA
Date Published
2024 Mar 12
chart icon Visual
Original
Study Summary
🔬
What They Studied
The study examined whether starting ADHD medication is linked to lower mortality risk in people with ADHD.
💡
What They Found
They found that beginning ADHD medication was associated with reduced all-cause and unnatural-cause death rates.
📚
What This Means
These findings align with current guidelines, suggesting ADHD medication can help manage the risk of adverse outcomes, including reduced death rates from unnatural causes, without altering current recommendations.
Study Overview
Background & Objectives
ADHD, or Attention Deficit Hyperactivity Disorder, affects both children and adults and is commonly treated with medications like methylphenidate (Ritalin), which helps boost focus by increasing levels of norepinephrine and dopamine in the brain.

Researchers aimed to explore whether starting medication shortly after an ADHD diagnosis could lower death rates among those with the disorder, given prior data suggesting various associated risks.
Abstract: background
To investigate whether initiation of ADHD pharmacotherapy was associated with reduced mortality risk in individuals with ADHD.
Study Summary
Methods
Researchers examined medical records from Sweden, selecting individuals aged 6 to 64 years diagnosed with ADHD between 2007 and 2018. None had taken ADHD medications before diagnosis. Follow-up began right after diagnosis and continued until death, leaving the country, a two-year period, or end of 2020.

They checked if ADHD medications were started within three months and tracked deaths over two years, distinguishing between natural and unnatural death causes.
Abstract: methods
In an observational nationwide cohort study in Sweden applying the target trial emulation framework, we identified individuals aged 6 t...more
Study Results
Results
The study included over 148,000 people with ADHD, a little over half started medication soon after diagnosis. Those who began treatment had a lower risk of dying within two years than those who did not. This suggests starting ADHD medication can decrease overall mortality risk.

The reduction was more apparent with unnatural causes of death, like accidents. However, starting medication didn't significantly affect the rate of deaths from natural causes.
Abstract: results
Of 148,578 individuals with ADHD (61,356 females [41.3%]), 84,204 (56.7%) initiated ADHD medication. The median age at diagnosis was 17...more
Study Summary
Conclusions
The findings suggest that for individuals diagnosed with ADHD, beginning medication may reduce their chances of dying, especially from unnatural causes. The study highlights the potential life-saving benefits of medication for ADHD patients.

While the results are promising, they mainly pertain to reducing mortality from unnatural causes, indicating the importance of proper management of ADHD symptoms to enhance overall safety and longevity.
Abstract: conclusions
Among individuals diagnosed with ADHD, medication initiation was associated with significantly lower all-cause mortality, particularly for death due to unnatural causes.
Visual Summary for ADHD Pharmacotherapy and Mortality in Individuals With ADHD
Clinical Guidelines
Guidelines suggest that ADHD medication lowers the risk of motor vehicle collisions, with a 38% risk reduction for males and 42% for females during treatment.

Stimulants can cause mild increases in heart rate and blood pressure, though monitoring is advised for a subset of patients with significant changes.

Treatment with ADHD medications has been associated with reducing risks of unnatural death and psychiatric comorbidities, including substance use disorders.
Literature Review
McCarthy et al, 2009
Core Insight:The main paper links ADHD medication to reduced mortality, especially unnatural causes. The comparison paper finds no increased risk of sudden death but notes a potential increase in suicide risk among younger patients.
What It Adds:
Focus on natural and unnatural causes: The main paper highlights reduced unnatural-cause mortality with ADHD medication.
Suicide risk in younger patients: The comparison paper identifies higher suicide risk in specific age groups, unrelated to sudden death.
Shared Themes:
Monitoring patient safety: Both papers emphasize the need for careful patient monitoring due to identified risks.
No sudden death risk: Both studies report no significant increase in sudden death with ADHD medications.
Literature Review
Zhang et al, 2022
Core Insight:The first paper finds that ADHD medication initiation is linked to a lower mortality risk, particularly for unnatural causes, while the second paper focuses on the cardiovascular risks associated with ADHD medications.
What It Adds:
Cardiovascular Risk: The second paper adds insight on cardiovascular risks, finding no significant link between ADHD medications and cardiovascular disease across age groups.
Focus on Safety: This paper suggests a modest risk for certain cardiovascular issues, including arrhythmias and cardiac arrest, especially in specific patient groups.
Literature Review
Chen et al, 2020
Core Insight:The comparison paper supports the primary paper's findings that ADHD medication is associated with lower all-cause and unnatural-cause mortality, emphasizing that delayed or shorter use may increase risk.
What It Adds:
Delayed medication use increases risk: The comparison study finds delayed ADHD medication use linked to higher mortality.
Longer medication use reduces risk: Longer use of ADHD medication shows reduced mortality in the comparison study.