Study Investigates Methylphenidate Treatment and Suicide Risk

Background on ADHD

Attention deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children, characterized by underperformance of the neurotransmitters dopamine and norepinephrine. These deficiencies primarily affect brain regions responsible for executive functions, such as reasoning and behavioral inhibition. Individuals with ADHD are recognized as having a heightened risk of suicide attempts.

Methylphenidate as a Treatment Option

Methylphenidate hydrochloride, a central nervous system stimulant, is frequently prescribed for ADHD management. Its mechanism involves inhibiting certain transporters in the central nervous system, which leads to increased levels of dopamine and norepinephrine. The estimated prevalence of ADHD among school-aged children globally ranges from 5% to 7%.

Study Overview

A population-based, retrospective study utilizing the Clinical Data Analysis and Reporting System (CDARS) developed by the Hong Kong Hospital Authority aimed to assess the potential association between methylphenidate treatment and suicide risk. Despite ongoing debates regarding this relationship, the findings were published in JAMA Psychiatry.

Findings of the Study

Among 25,629 patients receiving methylphenidate for ADHD, 154 individuals were identified as having attempted suicide. The researchers discovered that the incidence of suicide attempts during the 90 days prior to starting treatment was 6.5 times higher than baseline levels. In comparison, during the 90 days following the initiation of treatment, the incidence of suicide attempts showed a fourfold increase compared to baseline. Importantly, with ongoing treatment, the risk of suicide attempts eventually returned to baseline levels.

Interpretation of Results

These findings indicate that the decision to initiate methylphenidate treatment is often preceded by a heightened risk of suicide attempts. The authors suggest that this period may reflect changes in behavior and mental health symptoms that prompt individuals to seek medical consultation, ultimately leading to the prescription of methylphenidate. Although the risk remains elevated after treatment begins, it eventually declines.

Conclusion

The researchers emphasize that the study does not conclusively demonstrate that methylphenidate treatment directly lowers the risk of suicide attempts. Nevertheless, this significant study highlights that the increased risk of suicide attempts observed after starting methylphenidate for ADHD is not attributable to the medication’s effects.

Author Information

Written by Jade Marie Evans, MPharma, Medical Writer.

Reference

Kenneth K et al. (2017). “Association of Risk of Suicide Attempts With Methylphenidate Treatment”. JAMA Psychiatry. Available: https://app.luminpdf.com/viewer/4qHF8P6ASbMWH7zLR Last accessed 08/07/2017.