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Abstract
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PURPOSE: Epidemiologic findings are inconsistent regarding the association between attention-deficit/hyperactivity disorder (ADHD) medication exposure and suicide attempt in individuals with ADHD.
METHODS: A systematic literature search of PubMed, Embase and Cochrane Library up to February 2020 was performed. A meta-analysis was conducted for outcomes in which a summary risk ratio (RR) was calculated when taking heterogeneity into account.
RESULTS: Both population-level and within-individual analyzes showed that ADHD medication was associated with lower odds of suicide attempts (RR = 0.76, 95% confidence interval [CI], 0.58-1.00; P =.049 and RR = 0.69; 95% CI, 0.49-0.97; P =.049, respectively). However, the association only existed for participants who were treated with stimulants (RR = 0.72; 95% CI, 0.53-0.99; P =.042 on population-level analysis and RR = 0.75; 95% CI, 0.66-0.84; P < .001 on within-individual analysis). Furthermore, a lower risk of suicide attempts was not observed in subjects who took ADHD medication for 1 to 90 days (RR = 0.91; 95% CI, 0.74-1.13; P =.416 on within-individual analysis).
CONCLUSION: The results indicate that non-stimulant treatment is not associated with a higher risk of suicide attempt, but stimulant treatment is associated with a lower risk of suicide attempt.
Language: en |