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. 2017 Jun 1;74(6):597-603.
doi: 10.1001/jamapsychiatry.2017.0659.

Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes

Zheng Chang  1 , Patrick D Quinn  2 , Kwan Hur  3 , Robert D Gibbons  3 , Arvid Sjölander  4 , Henrik Larsson  5 , Brian M D'Onofrio  6
Affiliations

Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes

Zheng Chang et al. JAMA Psychiatry. .

Abstract

Importance: Motor vehicle crashes (MVCs) are a major public health problem. Research has demonstrated that individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to experience MVCs, but the effect of ADHD medication treatment on the risk of MVCs remains unclear.

Objective: To explore associations between ADHD medication use and risk of MVCs in a large cohort of patients with ADHD.

Design, setting, and participants: For this study, a US national cohort of patients with ADHD (n = 2 319 450) was identified from commercial health insurance claims between January 1, 2005, and December 31, 2014, and followed up for emergency department visits for MVCs. The study used within-individual analyses to compare the risk of MVCs during months in which patients received ADHD medication with the risk of MVCs during months in which they did not receive ADHD medication.

Exposures: Dispensed prescription of ADHD medications.

Main outcomes and measures: Emergency department visits for MVCs.

Results: Among 2 319 450 patients identified with ADHD, the mean (SD) age was 32.5 (12.8) years, and 51.7% were female. In the within-individual analyses, male patients with ADHD had a 38% (odds ratio, 0.62; 95% CI, 0.56-0.67) lower risk of MVCs in months when receiving ADHD medication compared with months when not receiving medication, and female patients had a 42% (odds ratio, 0.58; 95% CI, 0.53-0.62) lower risk of MVCs in months when receiving ADHD medication. Similar reductions were found across all age groups, across multiple sensitivity analyses, and when considering the long-term association between ADHD medication use and MVCs. Estimates of the population-attributable fraction suggested that up to 22.1% of the MVCs in patients with ADHD could have been avoided if they had received medication during the entire follow-up.

Conclusions and relevance: Among patients with ADHD, rates of MVCs were lower during periods when they received ADHD medication. Considering the high prevalence of ADHD and its association with MVCs, these findings warrant attention to this prevalent and preventable cause of mortality and morbidity.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Larsson reported serving as a speaker for Eli Lilly and Shire and reported receiving a research grant from Shire, all outside of the submitted work. No other disclosures were reported.

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References

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    1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System (WISQARS), 2016. http://www.cdc.gov/injury/wisqars/overview/key_data.html. Accessed September 16, 2016.
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    1. Asherson P, Buitelaar J, Faraone SV, Rohde LA. Adult attention-deficit hyperactivity disorder: key conceptual issues. Lancet Psychiatry. 2016;3(6):568-578. - PubMed

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