Children and adolescents suffering from attention deficit hyperactivity disorder (ADHD) have a lower risk of traumatic brain injury when taking methylphenidate or atomoxetine. This was shown in a longitudinal study of ADHD in children and adolescents in Germany performed by the Leibniz Institute for Prevention Research and Epidemiology - BIPS and funded by the German Federal Ministry of Education and Research. Results of the project have now been published in the American journal JAMA Pediatrics.
It is well known that people with ADHD suffer more often from accidental injuries such as fractures, head injuries, burns, and poisoning. However, until now, there was no clear evidence that therapy with methylphenidate or atomoxetine could reduce the increased risk of injury.
Scientists from the Leibniz Institute for Prevention Research and Epidemiology - BIPS and the Helmholtz Centre for Infection Research investigated this question in their study of children and adolescents with ADHD.
The study was based on the German Pharmacoepidemiological research database (GePaRD) with data from about 17 million insured persons from four statutory health insurance providers in Germany. The researchers identified 37,650 children and adolescents between the ages of three and 17 years newly diagnosed with ADHD in 2005 and 2006.
In this group, which was followed until 2009, 2,128 children and adolescents were hospitalized for injuries, including 821 with a diagnosis of traumatic brain injury.
For the 2,128 children and adolescents treated with an injury in hospital, the researchers recorded all prescriptions of methylphenidate and atomoxetine. It was found that just over half of them received a prescription of methylphenidate or atomoxetine during the observation period; 92 percent of the prescriptions were for methylphenidate. The researchers then compared the general risk of an injury or a traumatic brain injury under drug treatment during the observation period to the risk without treatment.
It was found that during drug treatment the probability of being admitted to hospital for traumatic brain injury was lower by 34 percent. However, if all injuries resulting in hospitalization were considered, the risk reduction did not reach statistical significance.
Prof. Dr. Edeltraut Garbe, head of the Department of Clinical Epidemiology at BIPS, explains: "Our study results indicate that children and adolescents with ADHD have a lower risk of traumatic brain injury if they are treated with methylphenidate or atomoxetine. Whether this is true for accidental injuries in general must be investigated further - our study suggests, but could not prove, this."
Mikolajczyk R, Horn J, Schmedt N, Langner I, Lindemann C, Garbe E. Accident prevention by medication among children with attention deficit/hyperactivity disorder (ADHD) - A case-only study. JAMA Pediatrics. 2015; http://dx.doi.org/10.1001/jamapediatrics.2014.3275
Leibniz Institute for Prevention Research and Epidemiology - BIPS
Department of Clinical Epidemiology
Prof. Dr. Edeltraut Garbe
Press office BIPS
Anja Wirsing | idw - Informationsdienst Wissenschaft
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