ADHD medications associated with reduced risk of suicidality
ADHD medications may lower suicide risk in children with hyperactivity, oppositional defiance, and other behavioral disorders, according to new research. The study was published in the JAMA Network Open.

Childhood suicidality rates are increasing, and attention-deficit/hyperactivity disorder (ADHD) and externalizing symptoms are common risk factors associated with suicidality. The objective was to investigate the associations of ADHD pharmacotherapy with externalizing symptoms and childhood suicidality.

Main and interaction associations of externalizing symptoms (hyperactivity ADHD symptoms, oppositional defiant, and conduct disorder symptoms) and ADHD medication treatment at baseline were assessed. Among 11 878 children at baseline assessment, 1006 were treated with ADHD medication, and 1040 reported past or current suicidality.

--Externalizing symptoms were associated with suicidality, as was ADHD medication treatment.

--ADHD medication use was associated with less suicidality in children with more externalizing symptoms, such that for children who were not receiving ADHD medications, there was an association between more externalizing symptoms and suicidality; however, for children who were receiving ADHD medication, there was no such association.

--The association with medication remained even when covarying for multiple confounders, including risk and protective factors for suicidality in ABCD, and was replicated in 1-year longitudinal follow-up.

--Sensitivity analyses matching participants with high numbers of externalizing symptoms taking and not taking ADHD medication treatment confirmed its association with less suicidality.

These findings suggest that ADHD medication treatment is associated with less suicidality in children with substantial externalizing symptoms and may be used to inform childhood suicide prevention strategies.