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ADHD Drugs Do Not Appear to Increase Suicidality — Physician’s First Watch

Medical News |
June 20, 2014

ADHD Drugs Do Not Appear to Increase Suicidality

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Drug therapy for attention-deficit/hyperactivity disorder does not appear to increase the risk for suicidal behavior, a BMJ study finds. In 2005, the FDA issued a warning about the risk for suicidal ideation in children and adolescents taking the ADHD drug atomoxetine.

Using Swedish registries, researchers followed nearly 38,000 people with ADHD from 2006 to 2009, examining suicide-related events during periods when patients were on and off drug therapy. Roughly 3300 people had at least one suicide-related event.

At the population level, ADHD drug therapy was associated with an increase in suicide-related events, but within-patient analyses showed no evidence of an increase in events when patients were on versus off treatment — either in the younger cohort (age 10-24 years at baseline) or older cohort. Treatment with the nonstimulant atomoxetine was not associated with increased risk, and treatment with stimulants (methylphenidate, amphetamine, dexamphetamine) was actually associated with a significant, 19% decrease in risk.

Barbara Geller of NEJM Journal Watch Psychiatry comments: "Higher population-level suicidality rates were no longer significant after excluding comorbid mood, conduct, and substance-use disorders, which supports comprehensive psychiatric evaluations before prescribing ADHD medications."

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