A study using Swedish national data shows that ADHD medicines, especially stimulants, not only facilitate basic symptoms but also linked to lower risk of dangerous results such as suicide efforts, substance abuse, accidents and crime.
Study: ADHD drugs and risk of suicidal behaviors, substance abuse, random injuries, accidents and crime accidents:. Credit Picture: Mobility Movies/Shutterstock.com
The hyperactivity disorder (ADHD) is a common neurodevelopmental condition. Its adverse effects on normal operation is well established, including increased risk of suicidal and addictive behaviors. The impact of the drug therapy on ADHD on such results is slightly understandable, preventing treatment decisions. A recent study at The bmj conducted in a test assimilation design aimed at taking light in the compounds of such results with medical treatment for ADHD.
Import
About 5% of children and 2.5% of adults have ADHD worldwide. It is mainly diagnosed in childhood. Its negative impacts include a higher risk of suicidal behavior, substance abuse, random injuries, transport accidents and criminal tendencies.
ADHD treatment includes pharmaceutical and non -pharmaceutical approaches, as well as combined strategies. Younger children, especially those in milder ADHD forms, are often treated without medication. However, ADHD medication, whether stimulant or non -stimulant, is widely used to treat older patients and can mitigate the severity of the basic symptoms.
The effect of treatment with drugs on other functional results remains unclear. Previous research is usually limited to groups that fulfill strict eligibility criteria, with the exception of about half of patients taking medicines in clinical practice. Epidemiological studies indicate that these functional results are improved when the patient is placed on ADHD drugs. However, these have not been tested for the effects of time and include only patients who have experienced one or more of these results.
Therefore, the current study attempted to imitate a randomized controlled test using observation data from Swedish national registries. This is called the target assimilation frame. He focused on first and repetitive events, choosing results based on discussions with people with ADHD.
Study findings
The researchers identified 148,581 people who were recently diagnosed with ADHD, 60% were men. The average age was 17.4 years. They watched for two years for the five results already mentioned.
About 57% of patients were placed in ADHD medication within three months of diagnosis. The most common primary drug was methylphenidate, prescribed at 88%, followed by a personal (non -stimulant) for 8%and Lisdexamfetamine for about 3%.
ADHD medicinal therapy was associated at a reduced rate of four of the five results, all except random injuries.
Overall, the risk of suicidal behavior was 17% smaller in the drug treatment group, after adjusting for other confusion factors. The incidence of substances was 85% of this non -drug treatment group and the incidence of transport accidents was 88%. The incidence of crime was 13% smaller in the drug treatment group.
Repeated Frequency of Events
Repeating these unwanted results is a common finding in ADHD. When only repetitive events were analyzed, the risk was reduced for all results. The risk of suicide behavior was 15% lower, crime and substance abuse was 25% less likely and transporting accidents were 16% lower, while accidental injuries showed a moderate reduction of 4%. This could reflect the highest chances of these patients to have severe ADHD and thus respond more easily to medicinal therapy.
The effect of starting the drug was more intense among those patients who had a history of any of these effects. For example, while medication was associated with 13% lower rates of suicidal behavior in people who have not taken into account history, a 21% decrease in those with a history of suicide behaviors. This is applied to all results.
Type
In comparing stimulants against non -stimulants, the former seemed to be more beneficial, with the impact rates of these results being between 71% and 97% of the rates with the latter. The most important difference was for substance abuse and crime, the least for random injuries.
Previous research supports these findings, with stimulants proven to improve the symptoms of the ADHD core better than non -stimulants. This could mitigate the risk of adverse functional results in the long run. Therefore, most guidelines advise the use of stimulants as a first -line treatment for ADHD.
Demographic agents
Adults were likely to have more significant improvements in the addiction and crime of substances compared to children. Female patients had a more significant reduction in crime than men, although previous studies suggest that males are more likely to have criminal behavior with ADHD. This can reflect a higher risk of such behavior among female patients with ADHD.
The risk of recurrent suicide behavior has been significantly improved by treatment with younger drugs compared to adults.
Conclusions
The study shows for the first time that the treatment of ADHD with medicines is associated with a reduced risk of suicidal behaviors and transport accidents in patients without a prior history. The effects on substance abuse, random injuries and crime were not important in this subgroup. In cases where such an event has already occurred, the risk of the five results that came back was reduced with drug treatment.
The stimulants seemed to be associated with a greater overall improvement. Separately, the reductions of recurrent suicidal behavior were important in children and young people. These changes may be due to lower impulsivity and better care and executive treatment, as previously randomized controlled tests have been proposed. Less impulsive behavior can prevent criminal acts and increased attention can prevent transport accidents.
While these findings confirm the findings of previous studies, the changes observed are smaller. Perhaps this is due to the design of the careful study that provided the full range of ADHD patients and not just those with a history of such effects that were drug -treatment. In addition, in current practice, drug therapy easily starts even with less severe symptoms.
As a result, this study attributed “The average effects of treatment reflect more the whole patient population and closer to estimates expected from randomized controlled tests. ”
The highest reduction in incident rates for repetitive events compared to events for the first time may indicate that “ADHD medicines can be associated with a actual decrease in events and not just postpone the appearance of these results. ”
The researchers also included type 1 diabetes as a result of negative control, which did not show correlation with ADHD medication, enhancing confidence in causal interpretation. These findings could help develop practical guidelines for such a treatment.
Magazine report:
- Zhang, L., Zhu, N., Sjolander, A., et al. (2025). ADHD therapy for drugs and a risk of suicidal behaviors, substance maltreatment, random injuries, transport accidents and crime: Target testing. The bmj. DOI: https://doi.org/10.1136/BMJ-2024-083658. https://www.bmj.com/content/390/BMJ-2024-083658