People with ADHD who take drugs to manage their symptoms have a lower risk of suicidal behaviours, criminal convictions, drug abuse, being accidentally injured or being in a road accident, according to a study of 150,000 people in Sweden. , but the researchers behind the latest study say this is the most reliable evidence so far.
鈥淭his is the best approach, the closest to a randomised trial,鈥� says at the Karolinska Institute in Sweden.
When drugs are considered for managing ADHD, the wider consequences of not taking them can be overlooked, says team member at the University of Southampton in the UK. For instance, parents tend to focus on the immediate issues their children are having at school, he says, but they should also be informed about the longer-term outlook.
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鈥淚f you don鈥檛 treat ADHD, there are risks,鈥� he says. 鈥淣ow we have evidence that treatment reduces these risks.鈥�
People with ADHD often have trouble paying attention and may make impulsive decisions. Randomised controlled trials show that .
These kinds of trials involve randomly assigning people to get a treatment or not, and they are regarded as the gold standard in medicine. But no randomised trials have looked at the wider effects of taking ADHD drugs. Instead, researchers have had to rely on observational studies, which aren鈥檛 set up to show whether taking the drugs actually cause the observed changes in symptoms or behaviour.
Now, Chang, Cortese and their colleagues have done what is known as target trial emulation, which involves analysing observational data as if it were from a randomised trial. They used data from Sweden鈥檚 medical and legal records to see how people fared in the two years following an ADHD diagnosis.
Compared with those who did not get medication during this time, those who started taking ADHD drugs within 3 months were 25 per cent less likely to get criminal convictions or have an issue with drugs or alcohol. They were also 16 per cent less likely to be involved in a road accident, 15 per cent less likely to attempt suicide and 4 per cent less likely to have accidental injuries.
鈥淚t鈥檚 always helpful to know if medications can impact daily life beyond reducing symptoms,鈥� at the University of Sydney in Australia told the Science Media Centre in the UK. 鈥淭his information is also important for governments to help policy-makers understand the potential benefits of treatment for broader society, such as mental health or criminal outcomes.鈥�
Need a listening ear? UK Samaritans: 116123 (samaritans.org); US 988 Suicide & Crisis Lifeline: 988 (988lifeline.org). Visit bit.ly/SuicideHelplines for other countries.
The BMJ
