In thinking about and discussing the potential benefits of treating ADHD with a stimulant medication, all concerned commonly focus on the benefits of being able to focus on reading or work, getting more things done, and so on.
Certainly, those are important to the patient. But I recommend that we should also take into consideration other potential benefits of treating ADHD with stimulant medications that are not typically discussed in clinical settings.
The treatment of ADHD with stimulant medications is not only very effective for the core symptoms of inattention, hyperactivity, and impulsivity, but has also been shown to reduce the risk of:
– Premature death (Schiavone et al., 2022; London and Landes, 2016; Dalsgaard et al., 2015)
– Serious traffic accidents (Chang et al., 2014a)
– Dying in a traffic accident (Dalsgaard et al., 2015)
– Substance use disorders (McCabe et al., 2024; McCabe et al., 2016; Chang et al., 2014b; Faraone and Wilens, 2007)
– Depression (Chang et al., 2016)
– Suicidal behavior (Rice et al., 2024; Chang et al., 2020; Chen et al., 2014)
– Criminal convictions (Lichtenstein et al., 2012)
– Violent reoffending (Lichtenstein et al., 2012)
Related Pages
ADHD medications—General
Tips for prescribing ADHD medications
Tips for managing abuse potential of medications for ADHD
Important interactions when using two medications for ADHD
How should ADHD be treated in persons with stimulant (including cocaine) use disorder
Stimulant medications—General
How are methylphenidate and amphetamines metabolized?
A dozen tips to manage loss of appetite due to a stimulant (in adults)
Converting stimulants: Equivalent doses
Pros and cons of short-acting preparations of psychostimulants
Tips for managing abuse potential of medications for ADHD
Stimulant medications and irritability in children with ADHD
Stimulants for ADHD with a history of a substance use disorder?
Don’t change the stimulant medication without first asking about this
What if you refuse an early refill of a stimulant medication?
What to look for in stimulant withdrawal (including a physical sign that is little known)
Stimulant “holidays” (breaks) in adults with ADHD?
How to get full-day coverage with stimulants
Do we need to worry about stimulant medications as our patients become older adults?
Clinical recommendations: What to do about stimulant medications in older adults
Can psychostimulant medications cause or worsen Raynaud’s phenomenon?
What can we do about the shortage of stimulant medications?
Laws about prescriptions for psychostimulants
Are stimulants useful after traumatic brain injury?
What to do about stimulant medications for surgery or other procedures under anesthesia
Amphetamine preparations
Amphetamine preparations: Index and links
Pros and cons of dextroamphetamine versus levoamphetamine.
Eight tips for reducing the risk of abuse/diversion of stimulants
Ketogenic diet and amphetamines
Vitamin C if on a stimulant?
Does lisdexamfetamine really have lower abuse potential?
Converting from OROS methylphenidate to amphetamine is a two-step process
Amphetamine (Dynavel-XR®) extended-release oral suspension: Basic information
Amphetamine extended-release orally disintegrating tablets (Adzenys XR-ODT): Basic information
What is the maximum dose of mixed amphetamine salts?
Do psychostimulant medications cause clinically-significant increases in blood pressure?
How exactly should blood pressure be monitored in persons on stimulants
How to manage stimulant-induced hypertension
When prescribing an amphetamine, warn patients about anti-acid medications
Dextroamphetamine (Dexedrine®): Basic Information
Lisdexamfetamine (Vyvanse®): Basic Information
Mixed amphetamine salts (Adderall®, Adderall XR®): Basic Information
Mixed salts of a single-entity amphetamine product (Mydayis®): Basic information
Triple-bead preparation of mixed amphetamine salts (Mydayis®)
Should we ever prescribe methamphetamine (Desoxyn®)?
Methylphenidate/ dexmethylphenidate preparations
Methylphenidate preparations: Index and links
OROS methylphenidate extended-release (Concerta®): Basic information
Should we prescribe dexmethylphenidate (Focalin) rather than methylphenidate (Ritalin)?
Converting from OROS methylphenidate to amphetamine is a two-step process
Methylphenidate (Ritalin, Ritalin SR®, Ritalin LA®): Basic information
Dexmethylphenidate (Focalin®, Focalin XR®): Basic Information
A psychostimulant preparation that is taken in the *evening* (Jornay PM®)
Combining stimulants with other medications
Combine a stimulant and atomoxetine?
Going from atomoxetine to an antipsychotic
Combining guanfacine and stimulants for ADHD
Can stimulant and antipsychotic medications be used together?
Changing from an antipsychotic to a stimulant
When a stimulant and an antipsychotic are used together and then the stimulant is stopped
Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined?
Can stimulant medications be used along with buprenorphine or methadone?
References
Chang Z, D’Onofrio BM, Quinn PD, Lichtenstein P, Larsson H. Medication for Attention-Deficit/Hyperactivity Disorder and Risk for Depression: A Nationwide Longitudinal Cohort Study. Biol Psychiatry. 2016 Dec 15;80(12):916-922. doi: 10.1016/j.biopsych.2016.02.018. Epub 2016 Feb 23. PMID: 27086545; PMCID: PMC4995143.
Chang Z, Lichtenstein P, D’Onofrio BM, Sjölander A, Larsson H. Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study. JAMA Psychiatry. 2014a Mar;71(3):319-25. doi: 10.1001/jamapsychiatry.2013.4174. PMID: 24477798; PMCID: PMC3949159.
Chang Z, Lichtenstein P, Halldner L, D’Onofrio B, Serlachius E, Fazel S, Långström N, Larsson H. Stimulant ADHD medication and risk for substance abuse. J Child Psychol Psychiatry. 2014 bAug;55(8):878-85. doi: 10.1111/jcpp.12164. Epub 2013 Oct 25. PMID: 25158998; PMCID: PMC4147667.
Chang Z, Quinn PD, O’Reilly L, Sjölander A, Hur K, Gibbons R, Larsson H, D’Onofrio BM. Medication for Attention-Deficit/Hyperactivity Disorder and Risk for Suicide Attempts. Biol Psychiatry. 2020 Sep 15;88(6):452-458. doi: 10.1016/j.biopsych.2019.12.003. Epub 2019 Dec 13. PMID: 31987492; PMCID: PMC7292769.
Chen Q, Sjölander A, Runeson B, D’Onofrio BM, Lichtenstein P, Larsson H. Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. BMJ. 2014 Jun 18;348:g3769. doi: 10.1136/bmj.g3769. PMID: 24942388; PMCID: PMC4062356.
Dalsgaard S, Østergaard SD, Leckman JF, Mortensen PB, Pedersen MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015 May 30;385(9983):2190-6. doi: 10.1016/S0140-6736(14)61684-6. Epub 2015 Feb 26. PMID: 25726514.
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London AS, Landes SD. Attention Deficit Hyperactivity Disorder and adult mortality. Prev Med. 2016 Sep;90:8-10. doi: 10.1016/j.ypmed.2016.06.021. Epub 2016 Jun 22. PMID: 27343403.
McCabe SE, Dickinson K, West BT, Wilens TE. Age of Onset, Duration, and Type of Medication Therapy for Attention-Deficit/Hyperactivity Disorder and Substance Use During Adolescence: A Multi-Cohort National Study. J Am Acad Child Adolesc Psychiatry. 2016 Jun;55(6):479-86. doi: 10.1016/j.jaac.2016.03.011. Epub 2016 Apr 7. PMID: 27238066; PMCID: PMC4921895.
McCabe SE, Figueroa O, McCabe VV, Schepis TS, Schulenberg JE, Veliz PT, Werner KS, Wilens TE. Is age of onset and duration of stimulant therapy for ADHD associated with cocaine, methamphetamine, and prescription stimulant misuse? J Child Psychol Psychiatry. 2024 Jan;65(1):100-111. doi: 10.1111/jcpp.13807. Epub 2023 Apr 16. PMID: 37062713; PMCID: PMC10852992.
Rice KM, Peltzman T, Gottlieb D, Shiner B, Watts BV. Stimulant medication and suicide mortality in attention-deficit hyperactivity disorder. BJPsych Open. 2024 Jan 22;10(1):e33. doi: 10.1192/bjo.2023.643. PMID: 38251676.
Schiavone N, Virta M, Leppämäki S, Launes J, Vanninen R, Tuulio-Henriksson A, Järvinen I, Lehto E, Michelsson K, Hokkanen L. Mortality in individuals with childhood ADHD or subthreshold symptoms – a prospective perinatal risk cohort study over 40 years. BMC Psychiatry. 2022 May 9;22(1):325. doi: 10.1186/s12888-022-03967-3. PMID: 35534804; PMCID: PMC9082906.
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