- A new study out of Sweden found that people taking ADHD medications had a lower mortality risk.
- About 9.8% of children in the U.S. have been diagnosed with ADHD.
- Experts say this study shows why it’s important for people with ADHD symptoms to get tested an receive treatment quickly.
A new study of people with attention deficit hyperactivity disorder (ADHD) suggested that medication for the condition was associated with an overall lower rate of mortality, particularly for unnatural causes of death.
Study followed people with ADHD for 11 years
The study, which incorporated data from national registries in Sweden, utilized a target trial emulation approach to determine whether starting medication for ADHD was associated with mortality in nearly 150,00 people.
The study was published March 12 in JAMA.
The median age for diagnosis of ADHD was 17.4 years, but the study examined people between the ages of 6 and 64 from Jan. 1, 2007, to Dec. 31, 2018, who had not taken any medication for ADHD for at least 18 months before their diagnosis.
The medications involved in the study were the six that were licensed in Sweden for the treatment of ADHD from 2007 to 2020: methylphenidate, amphetamine, dexamphetamine, lisdexamfetamine, atomoxetine, and guanfacine.
More than half of the people examined in the study — 84,204 — initiated medication treatment within three months of their diagnosis of ADHD; 64,296 did not take medication within that period. The crude 2-year mortality rate was nearly twice as low for people who took medication — 17.3 per 10,000 people — than those who did not — 31.8 per 10,000 people.
The results were even more pronounced among unnatural causes of mortality (eg, unintentional injuries, suicide, and accidental poisonings).
How is ADHD associated with higher mortality risk?
The study authors note that these findings show correlation, not causation meaning these findings are not proof of a direct link between these medications and mortality rates.
However, the authors point out there has not been much research on this subject previously and that there have only been three studies to examine this link.
The researchers also noted that this is the first study to “rigorously” examine the association of mortality with adults that have ADHD, and given the higher rate of comorbidities in adults with ADHD compared with children and teenagers, it does provide a larger window for examination.
According to the U.S. Centers for Disease Control and Prevention (CDC) as of 2022, the percentage of children in the U.S. between the ages of 3 and 17 who ever received a diagnosis of ADHD is 10.2%.
Prevalence of the diagnosis worldwide, the study authors note, is 5.9% in youths and 2.5% in adults; the U.S. prevalence is estimated as 9.8% for children and adolescents and 4.4% in adults. And those diagnosed with ADHD have a “2-fold increased risk of premature death” compared with those who are not, the authors state.
Dr. Thomas MacLaren, a member of the Royal College of Psychiatrists in England and a consultant psychiatrist at Re:Cognition Health Ltd. in London, who was not involved in the study, told Healthline that the study clearly shows an overall health benefit of starting medication for ADHD.
“This could give people with ADHD further encouragement to look at discussing medication for the condition with their doctor, and thinking more about long-term improvement to their general health and well-being, beyond just the treatment of their ADHD symptoms,” MacLaren said, adding that it is still unclear exactly how the medications would directly contribute to lower mortality. “As ADHD can be linked to poorer physical health, self-care, and even drug and alcohol use in some people, the extra benefits of having your symptoms controlled with the right medication could be helping boost health indirectly.”
Are certain ADHD medications better than others as far as mortality risk?
Dr. Lenard Adler, the director of the Adult ADHD Program at NYU Langone Health, who was not involved in the study, told Healthline that the study’s strengths lie in the number of people examined, the length of time, and the ability to look at potential effects of medications. However, data on how specific medications may have contributed to a reduced mortality rate was elusive.
“The study did not break out, in particular, differences amongst the medications that are approved for ADHD — they either did the stimulant medicines or the non-stimulant medicines,” Adler said. “And also you can’t attribute all of these potential changes, as the authors note, to just being due to medication; there may be lifestyle changes, which could have contributed to some of these effects.”
What does this mean for people with ADHD?
Adler said that while the study was limited as far as causality and differences between medications, it should be encouraging for anyone with ADHD or who is concerned about having it, as it offers evidence behind the benefits of treating ADHD.
“The important things here are that it, again, highlights appropriately if individuals are out there that are worried that they have ADHD to get a diagnosis and to get appropriate treatment, because we do have good treatments available,” Adler said. “I would like to see additional information regarding potential differences amongst the medications, and potentially longer observations in terms of treatment effects.”
MacLaren said further examination is needed for a number of factors surrounding ADHD medication, including lifestyle changes outside of pharmacological treatment.
“It would be good to take this further in clinical trials of ADHD to answer questions about whether they directly reduce the risk of developing certain health conditions; to make comparisons between different treatment regimens; and to correct for ‘confounders,’ including people who might already have healthier lifestyles,” MacLaren said. “You want to know if two similar people who have the same lifestyle, if one of them taking ADHD medication will lower their mortality or have other undiscovered benefits.”
Takeaway
An extensive study of nearly 150,000 people in Sweden with a diagnosis of ADHD suggested that those who took medication for ADHD had a lower overall mortality rate.
It is one of the first studies to examine the role of ADHD in mortality in adults, who often have more comorbidities associated with the condition than children or teenagers.
The study was associative, not causal, meaning there is not a direct link between specific medications and lower mortality.
