A recent study that included 148,000 people diagnosed with attention deficit hyperactivity disorder (ADHD) found that taking prescribed ADHD medications was linked to lower rates of premature deaths from unnatural causes like accidental drug and/or alcohol overdoses and unintentional injuries.
Researchers based in Europe and the U.S. followed close to 150,000 Swedish people with ADHD between 2007 and 2018. Their ages ranged from 6 to 64 years. The team observed the risk of premature death from natural and unnatural causes among those who started taking prescribed ADHD medications within three months of a diagnosis compared to those who remained unmedicated.
Around 56.7% of the participants were on either one of the six medications licensed for ADHD treatment in Sweden: methylphenidate, amphetamine, dexamphetamine, lisdexamfetamine, atomoxetine, and guanfacine. Whereas the other 43.3% of total participants did not opt for ADHD medication treatment.
Lead author of the study, Lin Li, a researcher at the Karolinska Institutet in Stockholm, Sweden, and colleagues noted that among medicated participants, the risk of dying from drug and alcohol overdose decreased the most. Among the male participants, they did not find any association between ADHD medication and reduced risks of dying from natural causes like a physical health condition. Interestingly, among the women who participated in the study, ADHD medication initiation was associated with a lower rate of natural-cause mortality.
“Although most ADHD medication initiators (91.9%) started with stimulants, initiation of stimulants vs non-stimulants showed no significant difference in terms of the all-cause mortality rate,” the researchers noted in the study, which was published in JAMA Network on March 12, 2024.
“ADHD medication may reduce the risk of unnatural-cause mortality by alleviating the core symptoms of ADHD and its psychiatric comorbidities, leading to improved impulse control and decision-making, ultimately reducing the occurrence of fatal events, in particular among those due to accidental poisoning,” the researchers wrote.
“Previous studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated. For instance, early and optimal treatment of ADHD may alter the trajectory of psychiatric morbidity by preventing the onset of comorbidities such as mood, anxiety, or substance use disorders,” they added. “There is also evidence showing that ADHD medications were associated with lower risk of accidents, substance use, and criminality, which in turn could lead to lower rates of unnatural deaths.”
Prior studies have concluded that stimulant medication like methylphenidate is linked to lower rates of smoking in adults, which results in better health outcomes. Other than that, multiple studies have found that methylphenidate is associated with improvements in emotional self-regulation, enhanced executive functioning, and decreased impulsivity which could further lower natural mortality risks linked to ADHD.
Despite these benefits, long-term usage of stimulant ADHD medication could impact people’s cardiovascular health irrespective of their age. A 2023 JAMA Psychiatry study found that using ADHD medications was linked to an increased risk of developing arterial disease and high blood pressure. Sweden-based researchers highlighted that more than one year of use heightened the relative risk of these cardiovascular diseases by 9% and two or more years had a 15% elevated risk. The percentage could increase to a 27% higher risk of cardiovascular disease after three or more years of taking an ADHD medication.
“The results of the current study were reassuring because ADHD medication was not associated with an increased risk of natural-cause mortality and, if anything, was associated with a reduced risk of natural-cause mortality in females. Nevertheless, future studies with larger sample sizes are warranted to confirm the relationship between ADHD medication use and natural-cause morbidity and mortality,” Li and team concluded in the study.
