Study: Patients with ADHD, Other Psychiatric Diagnoses Stop Treatment More Often

Individuals with attention-deficit hyperactivity disorder and other diagnoses who are taking stimulant medications are also more likely to switch to non-stimulant medications.

A recent study has found that individuals with attention-deficit hyperactivity disorder (ADHD) and other psychiatric diagnoses are more likely to stop taking their ADHD medications. The study is the largest of its kind to date, according to the authors, and the results were published in the American Journal of Psychiatry.

ADHD is among the most common psychiatric disorders diagnosed in childhood and is typically treated with medications. These medications include stimulants and non-stimulants, which are often used if a person does not respond well to the former. Both medication classes can reduce symptoms by increasing patients’ ability to focus and reducing hyperactivity and impulsivity.

Investigators collected data from 9133 patients diagnosed with ADHD and their prescriptions for medications in Denmark since 1995. They aimed to identify the genetic, clinical, and socio-demographic factors that impact the risk of stopping treatment with ADHD medications.

In a press release the researchers said that although stimulants are effective for most individuals with ADHD, they can sometimes cause adverse effects (AEs) and up to 50% of patients stop taking their ADHD medications within 2 years of initiating treatment. Notably, patients with another concurrent psychiatric diagnosis are more likely to stop taking their medications than those who do not have a second diagnosis.

“We discovered that people who have another psychiatric diagnosis in addition to ADHD, for example tics, anxiety, bipolar disorder, or some form of substance abuse, to a greater extent stop taking their stimulant medication or switch to a non-stimulant ADHD medication,” said study leader Isabell Brikell, PhD, BSc, MSc, in the press release.

This could potentially be attributed to a higher risk of AEs of a lower effect of simulants in individuals with more than 1 diagnosis. For example, the researchers said stimulants can lead to tics in some patients, which may cause them to stop taking their treatment or to try non-stimulant medications.

“It’s important to understand why so many [patients] stop taking their ADHD medication,” Brikell said in the press release. “Prior research has shown that the treatment can have positive effects on important parameters such as school performance and a lower risk of accidents and injuries for people with ADHD.”

The investigators also found evidence that a higher genetic risk of schizophrenia and bipolar disorder is linked with an increased risk of halting treatment with stimulant medications.

“Our findings confirm previous smaller studies by showing that certain psychiatric comorbidity may have a negative effect on the treatment outcomes for ADHD,” Brikell said in the press release. She added that the findings could help clinicians make appropriate treatment decisions when meeting newly diagnosed patients.

“With more knowledge about why and who has an increased risk of interrupting their treatment, we can better equip clinicians to give these people more targeted treatment, monitoring, and support,” she said.

The investigators are currently analyzing genetic information from more than 20,000 individuals with ADHD in order to test whether their findings can be confirmed and extended.

REFERENCE

People with ADHD and Multiple Psychiatric Diagnoses Stop Their ADHD Treatment More Often. News release. July 8, 2021. Accessed July 20, 2021. https://ipsych.dk/en/news/#news-20586