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Men with ADHD had a 38% lower risk of motor vehicle crashes (MVCs) when receiving ADHD medication, compared with months off medication. Women had a 42% lower risk, according to the results of a U.S. study.
Estimates suggested that up to 22% of MVCs in patients with ADHD could have been avoided if they had received medication during the whole length of the study, reported Zheng Chang, PhD, of the Karolinska Institutet, Sweden, and his colleagues (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659)
“This study is the first, to date, to demonstrate a long-term association between receiving ADHD medication and decreased MVCs,” said Dr. Chang and his associates. If this result demonstrates a protective effect, it is possible that continuous ADHD medication use might lead to lower risk of other problems, such as substance abuse disorder, or provide long-term improvements in life functioning for people with ADHD.
This study was supported by grants from the Swedish Research Council and the National Institute of Mental Health, as well as grants to two of the researchers from the Swedish Research Council for Health, Working Life and Welfare, and the National Institute on Drug Abuse. Dr. Chang and the other researchers had no relevant financial disclosures, except for Henrik Larsson, PhD, who received some speaker’s fees and research grants from pharmaceutical companies outside this work.
Prescribing medication to ADHD patients does not guarantee they will take it. Therefore, there is a chance that some of the motor vehicle crashes that occurred during a month when a patient reportedly was on medication may have occurred on a day when the patient had not actually taken medication. Also, using ED visits to measure the number of MVCs has a major drawback: vehicular accidents do not necessarily result in ED visits. Therefore, the study by Chang et al. may not accurately report the benefits of ADHD medication on safe driving.
Management of ADHD is not limited to school or the workplace but extends to other aspects of life, such as driving, which clinicians must consider when prescribing. It also is important to keep in mind, while prescribing, that the progression of ADHD often involves a decrease in hyperactivity during adulthood, while inattention and impulsivity may continue, and that the latter two traits can lead to distracted driving. Another important variable is that MVCs involving individuals with ADHD often happen later in the evening, when their medications may have worn off.
Customizing and improving ADHD pharmacotherapy, while being mindful of effects, is the most sensible way forward.
Vishal Madaan, MD, and Daniel J. Cox, PhD, are at the University of Virginia Health System in Charlottesville. Dr. Madaan reported receiving research support from Forest, Purdue, Aevi Genomic Medicine (formerly Medgenics), Sunovion, and Pfizer, as well as receiving royalties from Taylor & Francis. Dr. Cox reported receiving research support from the National Institutes of Health, Purdue, Johnson & Johnson, and Dexcom. They made these remarks in a commentary accompanying the study by Dr. Chang et al. (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659).
Prescribing medication to ADHD patients does not guarantee they will take it. Therefore, there is a chance that some of the motor vehicle crashes that occurred during a month when a patient reportedly was on medication may have occurred on a day when the patient had not actually taken medication. Also, using ED visits to measure the number of MVCs has a major drawback: vehicular accidents do not necessarily result in ED visits. Therefore, the study by Chang et al. may not accurately report the benefits of ADHD medication on safe driving.
Management of ADHD is not limited to school or the workplace but extends to other aspects of life, such as driving, which clinicians must consider when prescribing. It also is important to keep in mind, while prescribing, that the progression of ADHD often involves a decrease in hyperactivity during adulthood, while inattention and impulsivity may continue, and that the latter two traits can lead to distracted driving. Another important variable is that MVCs involving individuals with ADHD often happen later in the evening, when their medications may have worn off.
Customizing and improving ADHD pharmacotherapy, while being mindful of effects, is the most sensible way forward.
Vishal Madaan, MD, and Daniel J. Cox, PhD, are at the University of Virginia Health System in Charlottesville. Dr. Madaan reported receiving research support from Forest, Purdue, Aevi Genomic Medicine (formerly Medgenics), Sunovion, and Pfizer, as well as receiving royalties from Taylor & Francis. Dr. Cox reported receiving research support from the National Institutes of Health, Purdue, Johnson & Johnson, and Dexcom. They made these remarks in a commentary accompanying the study by Dr. Chang et al. (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659).
Prescribing medication to ADHD patients does not guarantee they will take it. Therefore, there is a chance that some of the motor vehicle crashes that occurred during a month when a patient reportedly was on medication may have occurred on a day when the patient had not actually taken medication. Also, using ED visits to measure the number of MVCs has a major drawback: vehicular accidents do not necessarily result in ED visits. Therefore, the study by Chang et al. may not accurately report the benefits of ADHD medication on safe driving.
Management of ADHD is not limited to school or the workplace but extends to other aspects of life, such as driving, which clinicians must consider when prescribing. It also is important to keep in mind, while prescribing, that the progression of ADHD often involves a decrease in hyperactivity during adulthood, while inattention and impulsivity may continue, and that the latter two traits can lead to distracted driving. Another important variable is that MVCs involving individuals with ADHD often happen later in the evening, when their medications may have worn off.
Customizing and improving ADHD pharmacotherapy, while being mindful of effects, is the most sensible way forward.
Vishal Madaan, MD, and Daniel J. Cox, PhD, are at the University of Virginia Health System in Charlottesville. Dr. Madaan reported receiving research support from Forest, Purdue, Aevi Genomic Medicine (formerly Medgenics), Sunovion, and Pfizer, as well as receiving royalties from Taylor & Francis. Dr. Cox reported receiving research support from the National Institutes of Health, Purdue, Johnson & Johnson, and Dexcom. They made these remarks in a commentary accompanying the study by Dr. Chang et al. (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659).
Men with ADHD had a 38% lower risk of motor vehicle crashes (MVCs) when receiving ADHD medication, compared with months off medication. Women had a 42% lower risk, according to the results of a U.S. study.
Estimates suggested that up to 22% of MVCs in patients with ADHD could have been avoided if they had received medication during the whole length of the study, reported Zheng Chang, PhD, of the Karolinska Institutet, Sweden, and his colleagues (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659)
“This study is the first, to date, to demonstrate a long-term association between receiving ADHD medication and decreased MVCs,” said Dr. Chang and his associates. If this result demonstrates a protective effect, it is possible that continuous ADHD medication use might lead to lower risk of other problems, such as substance abuse disorder, or provide long-term improvements in life functioning for people with ADHD.
This study was supported by grants from the Swedish Research Council and the National Institute of Mental Health, as well as grants to two of the researchers from the Swedish Research Council for Health, Working Life and Welfare, and the National Institute on Drug Abuse. Dr. Chang and the other researchers had no relevant financial disclosures, except for Henrik Larsson, PhD, who received some speaker’s fees and research grants from pharmaceutical companies outside this work.
Men with ADHD had a 38% lower risk of motor vehicle crashes (MVCs) when receiving ADHD medication, compared with months off medication. Women had a 42% lower risk, according to the results of a U.S. study.
Estimates suggested that up to 22% of MVCs in patients with ADHD could have been avoided if they had received medication during the whole length of the study, reported Zheng Chang, PhD, of the Karolinska Institutet, Sweden, and his colleagues (JAMA Psychiatry. 2017 May 10. doi: 10.1001/jamapsychiatry.2017.0659)
“This study is the first, to date, to demonstrate a long-term association between receiving ADHD medication and decreased MVCs,” said Dr. Chang and his associates. If this result demonstrates a protective effect, it is possible that continuous ADHD medication use might lead to lower risk of other problems, such as substance abuse disorder, or provide long-term improvements in life functioning for people with ADHD.
This study was supported by grants from the Swedish Research Council and the National Institute of Mental Health, as well as grants to two of the researchers from the Swedish Research Council for Health, Working Life and Welfare, and the National Institute on Drug Abuse. Dr. Chang and the other researchers had no relevant financial disclosures, except for Henrik Larsson, PhD, who received some speaker’s fees and research grants from pharmaceutical companies outside this work.
FROM JAMA PSYCHIATRY
Key clinical point:
Major finding: Patients with ADHD have 22% less risk for motor vehicle crashes when they are on medication.
Data source: Data were gathered from commercial insurance claims of a national cohort of 2,319,450 patients with ADHD and ED visits for motor vehicle crashes.
Disclosures: This study was supported by grants from the Swedish Research Council and the National Institute of Mental Health, as well grants to two of the researchers from the Swedish Research Council for Health, Working Life and Welfare, and the National Institute on Drug Abuse. Dr. Chang and the other researchers had no relevant financial disclosures, except for Dr. Larsson who received some speaker’s fees and research grants from pharmaceutical companies outside this work.