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Association between ADHD drug use and injuries among children and adolescents

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Abstract

To study the association between attention deficit hyperactivity disorder (ADHD) drug use and the incidence of hospitalization due to injuries. A random sample of 150,000 persons (0–18 years) was obtained from the Dutch PHARMO record linkage system. An ADHD medication cohort as well as an up to six age/sex/index date sampled control cohort with no history of ADHD drug use was formed. Differences in incidence of hospitalization due to injuries were stratified for age and sex and compared prior, during and after exposure on ADHD drugs. The overall incidence of hospital admissions for injuries was two times higher in the ADHD medication cohort [incidence rate ratios (IRR) 2.2 (95 % CI 1.6–2.9)]. The incidence rate for injuries during exposure to ADHD drugs was lower in the exposed period compared to the period prior to ADHD drug use, although the difference was not statistically significant [IRR 0.68 (95 % CI 0.29–1.60)]. The relative risk for injuries was almost five times higher in the ADHD medication cohort among those who concomitantly used other psychotropics [IRR 4.8 (95 % CI 1.4–16.9)]. Risk for injuries was highest in 12–18 years olds. Children and adolescents using ADHD medication showed a twofold risk for hospital admissions for injuries. ADHD drug use might diminish the increased injury risk, but still overall risk is higher than in age/sex sampled children and adolescents without treatment with ADHD drugs. Use of ADHD and concomitant psychotropics increases the risk for injuries compared to only ADHD drug use.

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Conflict of interest

E.vdB.: Janssen-Cilag BV: advisory board, reimbursed travel to convention; Lilly Nederland BV: reimbursed travel to convention; UCB Pharma BV: reimbursed travel to convention; Eurocept BV: reimbursed travel to convention. The division of Pharmacoepidemiology and Clinical Pharmacology employing authors P.S., T.E. and E.H. has received unrestricted funding for pharmacoepidemiological research from GlaxoSmithKline, Novo Nordisk, the private–public funded Top Institute Pharma (http://www.tipharma.nl, includes co-funding from universities, government, and industry), the Dutch Medicines Evaluation Board, and the Dutch Ministry of Health. No support or funding for this manuscript. The PHARMO Institute for Drug Outcomes Research performs financially supported studies for several pharmaceutical companies. No support or funding for this manuscript. The other authors W.M., H.vE and H.S. have no conflicts of interest.

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van den Ban, E., Souverein, P., Meijer, W. et al. Association between ADHD drug use and injuries among children and adolescents. Eur Child Adolesc Psychiatry 23, 95–102 (2014). https://doi.org/10.1007/s00787-013-0432-8

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  • DOI: https://doi.org/10.1007/s00787-013-0432-8

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