JAMA Psychiatry

As ADHD prescriptions climb, real-world benefits fail to keep pace

June 30, 2025

Study details: A population-based self-controlled case series analyzed 247,420 Swedish individuals aged 4 to 64 years who used ADHD medications between 2006 and 2020. Using national registry data, the study compared rates of self-harm, unintentional injury, traffic crashes, and crime during medicated vs. nonmedicated periods, stratified across three time intervals as ADHD medication prevalence increased from 0.6% to 2.8%.

Results: ADHD medication use was consistently associated with lower risks of self-harm (incidence rate ratio [IRR] range: 0.77–0.85), unintentional injury (IRR: 0.87–0.93), traffic crashes (IRR: 0.71–0.87), and crime (IRR: 0.73–0.84) across all age groups and sexes. However, the magnitude of these protective associations weakened over time as prescribing rates increased, particularly for unintentional injury, traffic crashes, and crime (P for trend < .01). Shifts in age and sex distribution didn’t fully account for this attenuation.

Clinical impact: While ADHD medications remain associated with reduced risk of several adverse real-world outcomes, the diminishing effect as prescribing expands highlight the need for ongoing evaluation of medication use and patient selection.

Source:

Li L, et al. (2025, June 25). JAMA Psychiatry. Increased Prescribing of Attention-Deficit/Hyperactivity Disorder Medication and Real-World Outcomes Over Time. https://pubmed.ncbi.nlm.nih.gov/40560574/