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The Royal College of Psychiatrists Improving the lives of people with mental illness

Stimulant medication for attention deficit hyperactivity disorder ‘protects against substance use disorders’

Embargoed until 11 July 2013

Children with attention deficit hyperactivity disorder (ADHD) who take stimulant medication are twice less likely to develop substance use problems in adolescence than those who don’t, according to new research published by the British Journal of Psychiatry.


Numerous studies have shown that children with ADHD are at increased risk of developing substance use disorders and nicotine dependence. Stimulant medication, which includes Ritalin, is the first choice medication treatment for people with ADHD. This study is the first prospective, longitudinal European study investigating the effect of stimulant medication on the development of substance use disorder in ADHD.


The research team studied 505 young people with ADHD, who were recruited from the Belgian, Dutch and German International Multicentre ADHD Genetics study. Some were taking stimulant medication for their ADHD, and others were not. The researchers also recruited 223 children without ADHD who acted as a control group. All the participants were followed up after 4 years, around the age of 16, and their alcohol, drug and nicotine use assessed.

The researchers found that those young people with ADHD who did not take stimulant medication had a 2 times higher risk of developing a substance use disorder compared to those who did take stimulant medication. They also had a 2.6 times higher risk of developing a substance use disorder compared to the control group. No significant differences in substance use were found between those who took stimulant medication and the control group. The researchers also found that those children who started stimulant medication at an earlier age were less likely to develop a substance use disorder.


Taking stimulant medication did not reduce the risk of developing nicotine dependence, as both the stimulant treatment and the no-stimulant treatment group had an increased risk of developing nicotine dependence compared to the control group.


Lead researcher Dr Stephen Faraone, of the SUNY Upstate Medical University in New York, said: "We found that stimulant medication has a protective effect on the development of substance use disorders in adolescence, and that children who start stimulant medication at a younger age are better protected. We didn’t find any impact on the development of nicotine dependence.


"It is possible that stimulant medication protects against substance use disorders by decreasing the core symptoms of ADHD, including impulsivity, and associated problems such as poor self-esteem and school failure, which can lead to drug and alcohol use."

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Groenman GP, Oosterlaan J, Rommelse NNJ, Franke B, Greven CU, Hoekstra PJ, Hartman CA, Luman M, Roeyers H, Oades RD, Sergeant JA, Buitelaar JK and Faraone SV. Stimulant treatment for ADHD reduces risk for developing substance use disorder. British Journal of Psychiatry, ePub ahead of print, 11 July 2013, 10.1192/bjp.bp.112.124784


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