Medicating for symptoms of ADHD can make significant differences for many individuals. In some cases, those changes may even sway the outcome in life and death decisions.
An observational study of just under 150,000 people diagnosed with attention deficit/hyperactivity disorder (ADHD) found those who took medication stood a slightly higher chance of surviving the two-year study period than those who went without.
Researchers led by the Karolinska Institute in Stockholm concede their study isn’t designed to tease apart cause and effect, but with limitations in mind, they suggest that managing the diverse symptoms of ADHD – which may include impulsiveness and poor planning – could reduce the risks that come with making hasty decisions.
“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 authors suggest in their recently published report.
What was once dismissed largely as the restlessness and recklessness of juvenile boys is now increasingly accepted as a category of brain functioning that affects all individuals, young and old.
Though the extent of behaviors vary from person to person, ADHD can make day-to-day tasks that demand focus and preparedness far more challenging.
Most of the time, the results are a matter of inconvenience or increased stress. Yet every now and then, an impulsive action or moment of ill-placed focus risks disaster. Randomized, control-based trials have found that pharmaceutical treatments of ADHD’s symptoms can reduce injuries, traffic collisions, and even the chances of committing a crime.
On the other hand, such medications may not be without risk in and of themselves. Most research has failed to conclusively identify any significant association between cardiovascular disease and ADHD medications, which can increase blood pressure and heart rate.
But a 2023 study suggested that “long-term use of ADHD medication was associated with an increased risk of CVD, especially hypertension and arterial disease”, and health risks may yet present in other ways.
To identify subtle influences on mortality caused by ADHD treatments, the researchers turned to national Swedish healthcare registries and identified 148,578 individuals aged 6 through 64 who had received a diagnosis between 2007 and 2018. Just over half of those identified took one of six licensed pharmaceuticals for their condition.
Following the data trail for each person in the registry for two years (or until they died or left the country), the researchers found roughly 17 out of every 10,000 individuals prescribed a medication died in that period from both natural and unnatural causes, compared with nearly 32 out of every 10,000 who didn’t have a prescription.
Breaking the numbers down further, additional analyses found ADHD medication taken by males of all ages was significantly linked with lower rates of mortality driven by unnatural causes but not natural causes. Among females, initiating some form of treatment was associated with lower rates of death from natural causes but not unnatural causes.
While previous studies have flagged the possibility of an early death by suicide resulting from untreated ADHD, the researchers found limited evidence to suggest this was a significant factor.
Any conclusions that can be made from the study need to keep the small numbers in mind. The differences in mortality, while significant, are still minor, leaving room for speculation as to what is going on.
The study cannot tell us why this relationship exists, but it is possible that being medicated could help some make safer or better health choices, which could reduce the risk of dying from natural conditions. Differences between males and females in the study could be interpreted as males being more likely to make rash decisions that have life-altering consequences.
“These findings underscore the need for further exploration of any sex difference in the relationship between ADHD treatment and mortality,” the researchers write, “to inform targeted interventions aimed at optimizing outcomes for both males and females with ADHD.”
This research was published in JAMA.
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