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ADHD medication may cut risk for STIs
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Adolescents and young adults with ADHD were at higher risk for STIs later in life compared with those without the disorder; however, ADHD medications may reduce this risk by as much as 41% in men, according to researchers in Taiwan.
“Increasing evidence supports the association between ADHD and various health-risk behaviors, such as risky driving, substance abuse and risky sexual behaviors, which have been associated with the core symptoms of ADHD, including executive dysfunction, problematic decision-making and impulsivity,” Mu-Hong Chen, MD, from the department of psychiatry at Taipei Veterans General Hospital, and colleagues wrote. “However, the association between ADHD and STIs has rarely been investigated, and findings have been conflicting.”
The researchers used data from the Taiwan National Health Insurance Research Database to examine the risk for STIs among adolescents and young adults. They compared the risk between 17,898 patients with ADHD and 71,592 age- and sex-matched controls without ADHD, who did not have STIs before study enrollment. Participants were enrolled from 2001 to 2009, with follow-up until the end of 2011. Chen and colleagues tracked related data, such as risk for HIV, syphilis, genital warts, gonorrhea, chlamydial infection and trichomoniasis, as well as data on psychiatric comorbidity and medication use for ADHD (methylphenidate or atomoxetine).
Their analysis showed a significant association between ADHD and subsequent risk for any STI (P < .001). During follow-up, adolescents and young adults with ADHD had a higher incidence of any STI compared with patients without ADHD (1.2% vs. 0.4%; P < .001). After adjusting for demographic data, psychiatric comorbidities and ADHD medications, adolescents (HR = 3.27; 95% CI, 2.51-4.25), young adults (HR = 3.57; 95% CI, 2.3-5.54), men (HR = 3.81; 95% CI, 2.88-5.04) and women (HR = 2.71; 95% CI, 1.85-3.96) with ADHD were likely to develop an STI later in life. The association between ADHD and risk for HIV, syphilis, genital warts, gonorrhea, chlamydial infection and trichomoniasis was significant for all comparisons (P < .001).
Among teens and young adults with ADHD, short-term users (HR = 0.7; 95% CI, 0.53-0.94) and long-term users (HR = 0.59; 95% CI, 0.37-0.93) of ADHD medications had a 30% and 41% lower risk for any STI during follow-up; however, these effects were observed only in men.
Patients in the ADHD group had a higher prevalence of psychiatric comorbidities, such as disruptive behavior disorder (13.5% vs. 0.3%, P < .001), alcohol use disorders (1.1% vs. 0.5%, P < .001) and substance use disorders (2.5% vs. 0.8%, P < .001). However, after adjustment, there was an association between substance use disorders and STIs only among women (HR = 3.87; 95% CI, 1.98-7.55).
“We recommend that clinical psychiatrists focus on the occurrence of risky sexual behaviors and the risk of STIs in patients with ADHD and emphasize that treatment with ADHD medication could be a protective factor for prevention of STIs,” Chen and colleagues wrote. “Future studies would be necessary to further investigate whether other ADHD treatments, such as family therapy or psychotherapy, are effective in preventing STIs.” – by Savannah Demko
- Reference:
- Chen M, et al. J Am Acad Child Adolesc Psychiatry. 2018;doi:10.1016/j.jaac.2017.09.438.
Disclosures: The authors report no relevant financial disclosures.