Live longer with ADHD meds?

In the very short-term…

In what is being called a “groundbreaking” study which “underscores the vital role of medication in managing ADHD," researchers from Sweden propose significant advantages to using medication to address the ADHD “condition,” writing:

Among individuals diagnosed with ADHD, medication initiation was significantly associated with lower mortality, in particular for unnatural causes.

The study, which was published in JAMA (the prestigious Journal of the American Medical Association), followed 148,578 people aged six to 64, between the years of 2007 and 2018, all of whom had been diagnosed with ADHD. Follow up was conducted from the time of their diagnosis until their death, emigration, the passage of two years, or December 31, 2020, whichever occurred first. Researchers were investigating all forms of death, and also specifically natural or unnatural causes.

What they found was that all-cause death statistics favored the cohort using medication, with 39.1 deaths per 10,000 people, as opposed to 48.1 deaths per 10,000 in the no-drug cohort, a relative decrease of 21 percent among the drug cohort.

Looking at natural deaths, there were 13.1 deaths per 10,000 in the drug-using cohort, as opposed to 14.7 per 10,000 in the no-drug cohort, a relative decrease of 11 percent. However, among unnatural deaths, 25.9 per 10,000 occurred within the drug-using cohort as opposed to 33.3 among the no-drug cohort, a relative decrease of 25 percent among the drug cohort.

MSM's favored study

Despite employing a short follow-up period, many media sources proclaimed the study's results to be an endorsement of treating treating ADHD with medication:

The full data from the study are not freely available, but the 11 percent decrease in drug cohorts, as compared with no-drug cohorts, for unnatural death by five years post-diagnosis was, according to the researchers' own criteria, not considered significant.

However, in the long-term…

Benefit?

Long-term studies on the use of drugs for ADHD do exist, however, and they consistently show no advantage for medicating the “disorder.” The MTA study, for example, funded by the NIMH (National Institute of Mental Health), concluded after eight years of follow-up that use of stimulants did not provide any benefit:

In nearly every analysis, the originally randomized treatment groups did not differ significantly on repeated measures or newly-analyzed variables (e.g. grades earned in school, arrests, psychiatric hospitalizations, or other clinically relevant outcomes).

Danger? Stimulant drugs and your heart

While long-term use of ADHD drugs may have had difficulty proving efficacy in treating ADHD-associated symptoms, studies have shown definite harms related to years of using stimulant drugs. In fact, a very similar study to the one cited above, which followed a large cohort of 278,027 people who were either diagnosed with ADHD or were taking ADHD drugs, examined the long-term risk of cardiovascular disease (CVD), and found that the longer a person takes these drugs, the higher the risk:

… longer cumulative duration of ADHD medication use was associated with an increased risk of CVD, particularly hypertension and arterial disease, compared with nonuse…

Unlike the abovementioned study, follow-up here was up to 14 years, and the researchers found that “each one-year increase of ADHD medication use was associated with a four-percent increased risk of CVD.” In particular, the risk for hypertension almost doubled with three to five years of using ADHD drugs, and the risk of developing arterial disease was 65 percent greater.

These results notwithstanding (the study precedes this latest one by some months), media reported the results of the latest study as “reassuring,” citing the 14% decrease in natural deaths among the drugged cohort as signifying that no one needs to worry about the adverse effects, “since some people may worry about the effect of stimulant medications on their hearts.”

No attempt was made to reconcile an increased risk of heart disease with a supposedly decreased chance of death.

Danger of diagnosis

The median age of those taking drugs in the latest study was 17.4, and most studies that examine the impact of taking stimulant medications for ADHD follow children and adolescents. Other studies highlight not only the effects of medication but of diagnosis itself, such as a 2022 study from Australia which suggested that children diagnosed with ADHD gained nothing from the diagnosis, and in fact may be more likely to engage in self-harm as a result.

In this cohort study, ADHD diagnosis was not associated with any self-reported improvements in adolescents’ QOL [quality of life] compared with adolescents with similar levels of H/I behaviors but no ADHD diagnosis. ADHD diagnosis was associated with worse scores in some outcomes, including significantly increased risk of self-harm.