Stimulant Medications Associated with Lower Risk of Suicidality in Teens with ADHD
Objective:
To compare rates of suicidality in patients with ADHD on stimulant vs non stimulant medications.
Background:
The prevalence of suicidality in teens is currently at its highest. Teens diagnosed with ADHD have been observed to have elevated rates of both suicidal attempts and ideation. Despite this concerning correlation, limited research has been conducted comparing the effects of stimulant and non-stimulant medications on suicidality within this group.
Design/Methods:
We undertook a retrospective cohort study by utilizing the TriNetX database. Our sample consisted of patients aged 12 to 18 diagnosed with ADHD, categorizing them based on whether they were on stimulant or non-stimulant medications. The analysis was controlled for variables like age, sex, race, ethnicity, as well as underlying mood and anxiety disorders.
Results:
In our study, we assessed a total of 20,735 patients in each cohort. Teens on stimulant medications had a 0.4% risk of suicide attempt and a 4.3% risk of suicidal ideation. Teens on nonstimulant medications had a 1.0% risk of suicide attempt and a 7.9% risk of suicidal ideation. Suicidal attempt had an odds ratio of 2.674 (95% CI: 2.05 – 3.48) and ideation had an odds ratio of 1.89 (95% CI: 1.74 – 2.06).
Conclusions:
Our findings highlight that stimulant medications are associated with a lowered risk of suicidal ideation and attempts in adolescents with ADHD, even after controlling for a wide variety of confounding variables. The reasons behind this lowered risk warrant further exploration, and such investigations might unveil novel therapeutic strategies or interventions. The evident difference in risk is noteworthy, suggesting that, particularly for patients with a history of suicidality, the efficacy and side effect profile of stimulant medications versus nonstimulant medications should be considered when developing a comprehensive care plan for ADHD.