ArticleBMJ (Clinical research ed.)2025
ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials.
Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Tolerance and Tachyphylaxis to Medications for Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Empirical Studies.CNS drugs · 2026Pooled it
- Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making.BMJ (Clinical research ed.) · 2025Pooled it
- Attention-Deficit/Hyperactivity Disorder Treatment Patterns and Association With Clinical Outcomes in Adolescents and Young Adults with Co-Occurring Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Retrospective Analysis.Journal of the American Academy of Child and Adolescent Psychiatry · 2026Article
- Treatment patterns and comparative clinical outcomes of ADHD medications in adolescents and young adults with comorbid major depressive disorder.Journal of affective disorders · 2026Article
- ADHD medication use and risk of self-harm: a multinational self-controlled case series study.BMJ mental health · 2026Article
- Comparative performance of large language models for appraising bias in real-world evidence studies.Journal of managed care & specialty pharmacy · 2026Article
- Clinical practices in ADHD management across Europe: findings from the ESCAP research academy survey.European child & adolescent psychiatry · 2026Article
- Mental health in elite athletes: International Olympic Committee consensus statement (2026).British journal of sports medicine · 2026Article
- Real-world ADHD pharmacological treatment patterns and their association with negative clinical outcomes in youth with comorbid autism: a Swedish population-based study.BMJ mental health · 2026Article
- Psychiatric and neurological predictors of early ADHD medication discontinuation across the lifespan: a multinational study.BMJ mental health · 2026Article
- Suicide attempt risk among patients receiving methylphenidate: a retrospective cohort study.Psychopharmacology · 2026Article
- Review
- Incidence of ADHD diagnoses and medication initiation among children and adolescents in Norway from 2016-2024.European child & adolescent psychiatry · 2026Article
- ADHD medication discontinuation and non-adherence: a Norwegian population-based register study.BMJ mental health · 2026Article
- Child and adolescent psychiatry: challenges, solutions, opportunities, and future directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Prescription psychostimulants or atomoxetine and the risk of stimulant-related hospital admissions in adults with and without stimulant use disorder: a Swedish population-based within-individual observational study.The Lancet regional health. Europe · 2026Article
- Guanfacine as a Treatment Option for Persistent Mental Restlessness and Deliberate Self-harm Thoughts in a Patient with Attention-deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Borderline Personality Disorder, and Post-traumatic Stress Disorder: Case Report.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- Psychiatric safety of methylphenidate in adults with major depressive disorder: a 1-year retrospective cohort study of 6,422 patients.Psychological medicine · 2026Article
- Attention Deficit Hyperactivity Disorder (ADHD) and Self-harm in Chinese Children and Adolescents: A Mediation by Resilience.Journal of autism and developmental disorders · 2026Article
- Commentary on Garas et al., "Longitudinal Suicide Risk in Children and Adolescents With Attention Deficit and Hyperactivity Disorder: A Systematic Review and Meta-Analysis".Brain and behavior · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
13 authors.
Funding
Abstract
objectiveTo examine the effects of drug treatment for attention deficit/hyperactivity disorder (ADHD) on suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality.
designEmulation of target trials.
settingLinkage of national registers in Sweden, 2007-20.
participantsPeople aged 6-64 years with a new diagnosis of ADHD, who either started or did not start drug treatment for ADHD within three months of diagnosis.
main outcome measuresFirst and recurrent events of five outcomes over two years after ADHD diagnosis: suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality.
resultsOf 148 581 individuals with ADHD (median age 17.4 years; 41.3% female), 84 282 (56.7%) started drug treatment for ADHD, with methylphenidate being the most commonly prescribed at initiation (74 515; 88.4%). Drug treatment for ADHD was associated with reduced rates of the first occurrence of suicidal behaviours (weighted incidence rates 14.5 per 1000 person years in the initiation group versus 16.9 in the non-initiation group; adjusted incidence rate ratio 0.83, 95% confidence interval 0.78 to 0.88), substance misuse (58.7
conclusionsDrug treatment for ADHD was associated with beneficial effects in reducing the risks of suicidal behaviours, substance misuse, transport accidents, and criminality but not accidental injuries when considering first event rate. The risk reductions were more pronounced for recurrent events, with reduced rates for all five outcomes. This target trial emulation study using national register data provides evidence that is representative of patients in routine clinical settings.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.