Study finds broad life gains from ADHD drugs

Medication to treat attention deficit hyperactivity disorder (ADHD) can have a positive impact on broader areas of patient life, lowering the risk of suicide, substance misuse, transport accidents and criminal behaviour, research suggests.
 
The study, published in the British Medical Journal, includes data from 148,581 patients aged 6–64 years, with an average age of 17, who had a new diagnosis of ADHD and had either started, or did not start, drug treatment within three months of their diagnosis.
 
It found 57% of patients were given drug treatment for their condition, with methylphenidate being the most commonly prescribed (88.4%).
 
Beyond core symptoms, the authors identified five broader adverse outcomes that occurred in other areas of life for people with ADHD: suicidal behaviours, substance misuse, accidental injuries, transport accidents and criminality.
 
The study drew on Swedish national register data between 2007–20 and investigated the first and recurrent events for these five outcomes over a period of two years from diagnosis.
 
ADHD medication was found to be associated with a 17% reduction for suicidal behaviour, 15% for substance misuse, 12% for transport accidents, and 13% for criminality. The reduction was not statistically significant for a first-time accidental injury.
 
For those who had recurrent events, ADHD medication was linked with reductions in all five outcomes: 15% for suicidal attempts, 25% for substance misuse, 4% for accidental injuries, 16% for transport accidents and 25% for criminality.
 
The authors suggest this could be a result of ‘reduced impulsivity’, which might lower criminality by curbing aggressive behaviour, and ‘enhanced attention’, which might decrease the risk of transport accidents by minimising distractions.
 
‘These results provide evidence on the effects of ADHD drug treatment on important health related and social outcomes that should inform clinical practice and the debate on the drug treatment of ADHD,’ the authors wrote.
 
They also highlight the importance of early intervention and accessible care.
 
Dr Stephen Bright, a Senior Lecturer of Addiction at Edith Cowan University, said the study provides ‘further evidence that stimulant medication treatments for ADHD can be life changing’, however, access barriers remain.
 
‘It is very difficult for many Australians to access a paediatrician or psychiatrist who is able to commence stimulant medication treatments where appropriate due to extensive waitlists, in addition to financial and regulatory obstacles,’ he said.
 
Many states have taken recent steps to improve patient access to ADHD diagnosis and treatment via GPs, enhancing the capacity of general practice to take on a greater role while reducing barriers that lead to delayed care.
 
Dr Tim Jones, Chair of RACGP Specific Interests Child and Young Person’s Health, says the study ‘reinforces the benefits of early intervention’ in what is ‘a long-term health condition that benefits from a whole-of-life approach’.
 
‘GPs remain best placed to identify and support ADHD with a focus on whole-of-patient care,’ he told newsGP.
 
‘This study highlights that the initial period of treatment for ADHD offers a powerful opportunity for GPs to regularly engage patients in broad life improvement with a focus on setting up long term sustainable goals.
 
‘Further long-term data on medication benefits and side effects in our adult patients is needed to guide long-term care.’
 
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ADHD attention deficit hyperactivity disorder