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Medication use decreased risk for brain injury hospitalization among adolescents with ADHD

Using medication for ADHD did not significantly affect risk for hospitalization for injury among children with ADHD, though medication did have a preventative effect on risk for brain injuries, according to study findings in JAMA Pediatrics.

“For both children and adults, studies have shown a positive association between ADHD and a higher risk of injuries, including motor vehicle crashes, fractures, head injuries, burns and poisoning. Risk of injury to children and adolescents with ADHD might be mediated by several factors, such as impairment of motor functions, developmental coordination disorders or other symptoms,” study researcher Rafael Mikolajczyk MD, PhD, of the Leibniz Institute for Prevention Research and Epidemiology in Bremen, Germany, and colleagues wrote.

Researchers used data for 17 million insurers from four statutory health insurance providers in Germany to identify children aged 3 to 17 years with new diagnoses of ADHD in 2005 and 2006 (n = 37,650) who had an inpatient injury diagnosis during follow-up through 2009. Researchers also noted if children were prescribed methylphenidate or atomoxetine for ADHD.

Overall, 2,128 children experienced at least one hospitalization with an injury diagnosis during the study period. Approximately 80% of these children were boys.

More than half of children (53.9%) were prescribed methylphenidate or atomoxetine during the study period. The majority of prescribed doses were methylphenidate (92%).

During periods with medication, there was an insignificant risk reduction in hospitalization for any injury diagnosis and a 34% risk reduction in hospitalization for brain injury.

Researchers found no indication that hospitalization led to increased initiation of medication.

“In our study, the risk for any type of injury while taking ADHD medication was reduced to a lesser degree compared with the risk of brain injuries, which is consistent with previous studies indicating that children and ADHD are particularly prone to brain injuries. The risk reduction for hospitalizations with any type of injury diagnosis missed statistical significance, but the point estimates were directed toward a risk reduction,” Mikolajczyk and colleagues wrote. – by Amanda Oldt

Disclosure: Mikolajczyk reports financial ties with Bayer, Celgene, GlaxoSmithKline, Mundipharma, Novartis, Sanofi, Sanofi Pasteur MSD and STADA. Please see the full study for a list of all other authors’ relevant financial disclosures.