Clinical relevance: ADHD diagnoses among U.S. children have increased, but traditional treatments like stimulants and non-stimulants show unexpected benefits.

  • Research published in Jama Network Open indicates that medications like lisdexamfetamine can lower the risk of psychiatric hospitalization and suicidal behavior, while atomoxetine reduces workplace disabilities, particularly in adolescents and young adults.
  • A study from Karolinska Institutet in Sweden reveals a link between ADHD medication and a 25% lower risk of premature death, especially from unnatural causes like overdose.
  • While the observational nature of the study can’t establish causation, early treatment of ADHD appears crucial, prompting further research into long-term effects and potential adverse outcomes.

Despite a persistent uptick – at least one out of every 10 U.S. children between 5 and 17 have received an ADHD diagnosis since 2020 – things are looking up. A pair of Swedish studies have uncovered a host of unexpected benefits from traditional attention deficit hyperactivity disorder (ADHD) treatments.

Traditional Treatments Show Unexpected Benefits

The latest study, appearing in the March issue of Jama Network Open, found that the use of traditional ADHD medications, such as the stimulants lisdexamfetamine, dexamfetamine/dextroamphetamine, amphetamine, and methylphenidate, is tied to a lower risk of psychiatric hospitalization, suicidal behavior, and non-psychiatric hospitalizations. 

The research showed that lisdexamfetamine in particular appeared to be effective at mitigating the risk of psychiatric hospitalization and suicidal behavior. The non-stimulant treatment atomoxetine, on the other hand, reduced the threat of suffering a debilitating injury on the job. It showed a stronger influence on adolescents and young adults.

“Although concerns have been raised about the potential of amphetamines and methylphenidate for increasing the risk of adverse psychiatric outcomes, such as psychosis and mania, our results show that overall the net effect on psychiatric outcomes is positive,” the researchers wrote. “This is in line with several previous studies showing decreased risk of suicidal behavior and development of substance use disorder, as well as lower rates of occurrence and reoccurrence of depression during ADHD drug use.”

The scientists combed through nationwide data from 221,714 people aged 16 to 65 with an ADHD diagnosis. The data showed that more than 56 percent of them endured a psychiatric comorbidity. Anxiety or stress-related disorders – 24 percent – and depression and/or bipolar disorder – 19.5 percent – emerged as the most prevalent conditions.

Additionally, the research team examined the links between specific pharmaceutical treatments and hospitalizations, psychiatric or otherwise, workplace disabilities (which the researchers defined as an absence of more than 14 days and/or disability pension), and suicides or suicide attempts).

“Considering the high prevalence of psychiatric comorbidity in persons with ADHD,” the researchers said, “these results suggest that ADHD medication use can reduce morbidity in adolescents and adults with ADHD.”

ADHD Medications Prevent Premature Deaths

The study follows earlier research from the same institution – Karolinska Institutet in Stockholm, Sweden – that uncovered a connection between ADHD medication and a lower risk of premature death. Specifically, ADHD medication reduces the risk of accidental and overdose deaths by a quarter.

This more recent study looked at nearly 150,000 Swedes aged 6-64, who received an ADHD diagnosis between 2007 and 2018. The researchers dug into the risk of death for up to two years after the initial diagnosis and compared it against those who started treatment within three months of diagnosis with those who didn’t.

“The study showed that there is a link between initiation of medication and a lower risk of death,”  lead author and postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet Lin Li said in a press release. “This was true regardless of the cause of death, but the risk of dying from unnatural causes, such as alcohol and drug overdose, decreased the most. The association was not as strong for the risk of dying from natural causes as a physical health condition.”

The researchers emphasized that since this was an observational study, it couldn’t establish a causal relationship. Nevertheless, the researchers insist that the results suggest that early treatment could be critical for anyone with ADHD.

The team plans to continue their research by taking a harder look at the longer-term effects of ADHD medication.

“It will be crucial to establish whether the benefits we have seen in this study will persist over time. We will also try to identify any additional adverse effects associated with long-term medication,” study co-author Zheng Chang added.

Further Reading

ADHD Might Have Been an Early Evolutionary Edge

FDA Announces ADHD Drug Recall

How Long-Term ADHD Med Use May Raise Cardiovascular Risk