ADHD Medicines Reduce Suicide, Crime Risks In Sweeping Study

Drugs to treat attention deficit hyperactivity disorder were linked to a reduced risk of suicidal behavior, substance misuse and criminality in the first research of its kind.

The findings come amid increasing debate around whether ADHD is being over-diagnosed and therefore over-treated with drugs like Ritalin. The research published in the British Medical Journal on Wednesday did not investigate whether patients are being accurately diagnosed, but it does provide evidence supporting medical treatment.

ADHD is characterized by difficulties with concentration and impulse control. Roughly 5% of children and 2.5% of adults are estimated to have the condition, which is also associated with an increased risk of substance misuse and self-harm. The researchers wanted to test whether the risk changed with medication.

The study design was meant to closely mirror a randomized clinical trial, considered the gold standard of research. The scientists looked at health registry data from almost 150,000 patients newly diagnosed with ADHD in Sweden. At a two-year follow-up, they found that patients taking medicine had a 17% reduction in suicidal behavior and a 15% drop in substance misuse. They also found declines in the risk for criminality and transport accidents. When looking at the recurrence of these behaviors, there were also benefits linked to the medication.

While the trial cannot show direct causation and could be confounded by factors such as ADHD severity, it provides doctors with vital evidence showing that drugs can address and reduce important risks, according to one of the authors. "These data should inform clinical guidelines, policies and current debates," said Samuele Cortese, a professor of child and adolescent psychiatry at the University of Southampton.

The benefit was greater for patients taking stimulant medications than non-stimulants in the study. Stimulants include drugs like Novartis AG's Ritalin, while non-stimulants include Eli Lilly & Co.'s Strattera.

The study results echo other similar conclusions, but "the large sample size, use of a national registry, and more sophisticated analysis give greater confidence in these results that findings aren't explained by something else other than medication use," said Adam Guastella, a clinical psychologist who works at Sydney Children's Hospital at Westmead and the University of Sydney's Brain and Mind Center. He was not involved in the research.

Prescriptions in England for ADHD medicines have increased 18% year on year since the Covid-19 pandemic, according to research published in the BMJ Mental Health this year. The surge is believed to be linked to greater awareness of the condition.

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