Children who take ADHD medication have fewer thoughts of suicide

According to a study published in JAMA Psychiatry, it was found that pharmacotherapy for attention deficit / hyperactivity disorder (ADHD) was associated with fewer thoughts of suicide in children aged 9 and 10 who were diagnosed with ADHD.

ADHD is associated with psychiatric comorbidities, including suicidal ideation, attempted suicide, and committed suicide. Although other studies have looked at the link between ADHD drugs and suicide, these researchers wanted to take a more detailed approach.

The researchers used a large, diverse cohort from the Adolescent Brain Cognitive Development (ABCD) study, which enrolled 11,878 baseline children, ages 9 or 10. The researchers performed a follow-up after 1 year. Methylphenidate derivatives, amphetamine derivatives, α-2 agonists and atomoxetine were considered as ADHD drugs. The covariates included age, gender, race, ethnicity, parenting education (average duration), parental marital status, and child psychiatric pharmacotherapy such as antidepressants or antipsychotics.

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Of the 11,000+ children in the ABCD study, 8.5% were treated with ADHD medication and 8.8% reported past or current thoughts of suicide. The researchers found associations of externalizing symptoms and ADHD drugs with suicidal ideation. In children who did not receive ADHD medication, more externalizing symptoms were associated with a higher likelihood of suicidal thoughts; However, children on medication did not have such an association. The results were replicated in a one-year longitudinal analysis.

“The results provide a simple, actionable goal for optimizing prevention plans and intervention strategies for elementary school children with externalizing problems,” the researchers say. “Early diagnosis and treatment with ADHD drugs, especially in children with severe externalizing symptoms, can not only serve to improve learning and behavioral problems, but also to reduce the risk of suicidality.”

In addition, “Childhood suicidality is linked to adult psychiatric morbidity and mortality and may therefore be an early marker of lifelong susceptibility to poor mental health.”

However, the study did not take into account the mental health measures that may have influenced the results. The association between medication and suicidal ideation was analyzed using a one-sided test. Participants who lost follow-up reported a slightly higher rate of externalizing symptoms. In addition, the study did not evaluate thoughts and behaviors over a long period of time.

Disclosure: A study author stated links with biotech, pharmaceutical, and / or device companies. For a full list of the author’s disclosures, see the original reference.


Shoval G, Visoki E, Moore ™ et al. Evaluation of drugs against attention deficit / hyperactivity disorder, externalizing symptoms and suicidality in children. JAMA network open. 2021; 4 (6): e2111342. doi: 10.1001 / jamanetworkopen.2021.11342

This article originally appeared on Psychiatry Advisor

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