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A new study conducted by researchers at the Karolinska Institute in Stockholm, Sweden, found that individuals with attention-deficit/hyperactivity disorder (ADHD) who were prescribed ADHD stimulant medications had a lower risk of attempting suicide or dying by suicide. This study, which included 221,714 adults and adolescents with ADHD, also revealed that the use of ADHD medications was associated with fewer psychiatric hospitalizations. The researchers observed that four ADHD medications – amphetamine, lisdexamphetamine, dexamphetamine, and methylphenidate – were linked to a decreased risk of being hospitalized due to psychiatric co-morbidities.

The study found that a decreased risk of suicidal behavior was specifically associated with the use of lisdexamphetamine, dexamphetamine, and methylphenidate. Another study conducted in 2019 in Sweden showed that individuals with ADHD had a higher prevalence of psychiatric co-morbidities compared to those without ADHD. These co-morbidities included conditions like major depressive disorder, panic disorder, substance abuse, generalized anxiety disorder, and PTSD. The presence of psychiatric co-morbidities was also found to increase the risk of mortality, especially when substance use disorder was involved.

While atomoxetine, another ADHD medication, was not linked to a lower risk of psychiatric hospitalizations or suicidal behavior, the researchers did find an association between atomoxetine and fewer hospitalizations for non-psychiatric co-morbidities. The researchers pointed out that there is evidence suggesting that ADHD medications, especially stimulants, can improve functioning and quality of life in individuals with ADHD. However, there is still limited information available about the long-term effectiveness and safety of these medications.

The study included individuals between the ages of 16 to 65 who resided in Sweden and had received an ADHD diagnosis between 2006 to 2021. The researchers analyzed the participants’ healthcare data collected from the Swedish National Patient Register and tracked their prescribed ADHD medication purchases through the Prescribed Drug Register. Methylphenidate was the most commonly used medication, followed by lisdexamphetamine and atomoxetine. The participants underwent a 15-year follow-up period, with 56% of them having a psychiatric co-morbidity and 26% being hospitalized for psychiatric reasons.

Interestingly, lisdexamphetamine was found to be effective in reducing the risk of psychiatric hospitalizations among adolescents, young adults, and adults over 30, while methylphenidate seemed to be less effective in older adults. Atomoxetine, on the other hand, was associated with a decreased risk of hospitalization among women but not men. Overall, the researchers found that the use of ADHD medications had a beneficial effect on psychiatric outcomes and a decreased risk of non-psychiatric hospitalizations. However, they also highlighted concerns about long-term stimulant use potentially leading to adverse outcomes such as increased blood pressure, heart rate, cardiovascular diseases, seizures, and possibly psychosis or mania.

The study, published online on JAMA Network Open on March 20, 2024, provides valuable insights into the association between specific ADHD medications and the risk of psychiatric hospitalizations in individuals with ADHD. The findings suggest that the use of certain ADHD medications, particularly stimulants like lisdexamphetamine, dexamphetamine, and methylphenidate, may help reduce the risk of suicidal behavior and psychiatric hospitalizations among individuals with ADHD. Further research is needed to better understand the long-term effectiveness and safety of ADHD pharmacotherapies in managing psychiatric co-morbidities in individuals with ADHD.

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