ADHD Medication Use Lowers the Risk of Death, Hospitalization: Study
ADHD medication use lowers risk of death by 19%, risk of overdose by 50%, and it reduces hospitalizations, according to new, large-scale studies.
April 5, 2024
Treating ADHD with medication can lower overall risk of mortality and of hospitalizations, both psychiatric and non-psychiatric, according to two new Swedish studies.1, 2 These findings highlight the importance of ADHD medication use for long-term health and longevity, underscoring the urgent need to end the stimulant shortage that has prevented U.S. patients with ADHD from consistently accessing medication since the Fall of 2022.
Lower Risk of Death from All Causes
An observational study from Sweden, published in JAMA, followed nearly 150,000 adults and adolescents with a diagnosis of ADHD, tracking participants for two years following diagnosis.
The researchers found that use of ADHD medication:
- Reduced overall risk of death by 19%: Among people with ADHD who did not receive medication, there were 48 deaths for every 10,000 people, contrasted with 39 deaths per 10,000 people within the medicated cohort.
- Reduced risk of overdose by 50%: Medication use also reduced the risk of death from other unnatural causes, including accidental injuries, accidental poisoning such as drug overdoses, and suicide. This trend was particularly pronounced among men and significant in the category of accidental poisoning, where risk of death was lowered by almost 50%.
- Reduced risk of death from natural causes for women: ADHD medication use reduced the risk of death from natural causes, such as medical conditions, for women. Though it did not reduce this risk for men, medication use did not increase risk either. This is an important finding that may alleviate long-standing worries about the impact of stimulant use on cardiovascular health, among other concerns.
While the authors of the study caution that these findings show correlation, not causation, the results are encouraging for patients and clinicians with reservations about ADHD medication use, especially later in life.
Fewer Hospitalizations
A second Swedish study sought to investigate the effect of a variety of ADHD medications on rates of hospitalizations. Published in JAMA Network Open, the cohort study used nationwide medical and administrative databases to identify 221,000 people with ADHD, 56% of whom had a psychiatric comorbidity including anxiety or stress-related disorder (24%), and depression or bipolar disorder (20%). These individuals were then followed for up to 15 years.
The study found that a patient’s use of amphetamine, lisdexamphetamine, dexamphetamine, and/or methylphenidate significantly lowered the risk of:
- Suicidal behavior
- Psychiatric hospitalization
- Non-psychiatric hospitalization
Untreated ADHD in Adults Leads to “Dire Consequences”
The authors of the study featured in JAMA Network Open believe that the decrease in hospitalizations reflects the fact that ADHD medication use is associated with decreased risk for suicide attempts,3 substance use disorder,4 depression,5 car accidents,6 and unintentional injuries.7
“Impulsivity in adults can lead to dire consequences. The idea is that by improving impulsiveness and executive functioning, people are able to make better decisions,” explains Frances Levin, M.D., author of the JAMA editorial “Treating Attention-Deficit/Hyperactivity Disorder Matters,” 8 in a recent interview. “If you’re dealing with a substance use disorder (SUD) population, treating the ADHD allows them to better utilize clinical treatment for their SUD, and therefore reduce their risk of substance use and reduce accidental poisoning or overdose.”
“A Significant Public Health Problem”
The mortality risk study emphasizes the importance of treating ADHD, Levin explains: “Unlike other conditions, there’s often a sense that ADHD is over-hyped or it’s not a big deal, but this article demonstrates that this group is at higher risk of having both substantial morbidity as well as mortality.”
ADHD expert Russell A. Barkley, Ph.D., echoes this sentiment, stressing that ADHD is the number one factor affecting mortality for people with the condition. In other words, ADHD is not just a mental health issue; it’s a significant public health problem.
Barkley published a study in the Journal of Attention Disorders that found adults with ADHD could expect an 11- to 13-year reduction in life expectancy compared to neurotypical peers of a similar age and health profile.9
However, most of the ADHD-related factors impacting life expectancy — impulsivity, risky behavior, and inattention, to name a few — can be improved with interventions. Behavioral programs designed to improve overall health will also improve life expectancy, but only if ADHD symptoms are under control first, Barkley says. That requires more accurate diagnosis and more thoughtful treatment.
“When adults ask me questions about why they should try medication to manage their ADHD, my answer always comes down to two words: Medication works,” Barkley says in the ADDitude article, “Adult ADHD Treatment Options.” “When you find the right medicine, you can experience substantial improvements in your ADHD symptoms.”
Sources
1 Li L, Zhu N, Zhang L, et al. (2024). ADHD Pharmacotherapy and Mortality in Individuals With ADHD. <em>JAMA.<em>doi:10.1001/jama.2024.0851
2 Taipale H, Bergström J, Gèmes K, et al. Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes. JAMA Netw Open. 2024;7(3):e242859. doi:10.1001/jamanetworkopen.2024.2859
3 Chang Z, Quinn PD, O’Reilly L, et al. Medication for attention-deficit/hyperactivity disorder and risk for suicide attempts. Biol Psychiatry. 2020;88(6):452-458. doi:10.1016/j.biopsych.2019.12.003PubMedGoogle ScholarCrossref
4 Chang Z, Lichtenstein P, Halldner L, et al. Stimulant ADHD medication and risk for substance abuse. J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164PubMedGoogle ScholarCrossref
5 Chang Z, D’Onofrio BM, Quinn PD, Lichtenstein P, Larsson H. Medication for attention-deficit/hyperactivity disorder and risk for depression: a nationwide longitudinal cohort study. Biol Psychiatry. 2016;80(12):916-922. doi:10.1016/j.biopsych.2016.02.018PubMedGoogle ScholarCrossref
6 Chang Z, Quinn PD, Hur K, et al. Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes. JAMA Psychiatry. 2017;74(6):597-603. doi:10.1001/jamapsychiatry.2017.0659ArticlePubMedGoogle ScholarCrossref
7 Ghirardi L, Chen Q, Chang Z, et al. Use of medication for attention-deficit/hyperactivity disorder and risk of unintentional injuries in children and adolescents with co-occurring neurodevelopmental disorders. J Child Psychol Psychiatry. 2020;61(2):140-147. doi:10.1111/jcpp.13136PubMedGoogle ScholarCrossref
8 Levin FR, Hernandez M, Mariani JJ. Treating Attention-Deficit/Hyperactivity Disorder Matters. JAMA. 2024;331(10):831–833. doi:10.1001/jama.2024.1755
9Barkley, R. A., & Fischer, M. (2019). Hyperactive Child Syndrome and Estimated Life Expectancy at Young Adult Follow-Up: The Role of ADHD Persistence and Other Potential Predictors. Journal of Attention Disorders, 23(9), 907-923. https://doi.org/10.1177/1087054718816164
