Medication for Attention-Deficit/Hyperactivity Disorder and Risk for Depression: A Nationwide Longitudinal Cohort Study

Biol Psychiatry. 2016 Dec 15;80(12):916-922. doi: 10.1016/j.biopsych.2016.02.018. Epub 2016 Feb 23.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with high rates of psychiatric comorbidity, including depression. However, it is unclear whether ADHD medication increases or decreases the risk for depression.

Methods: We studied all individuals with a diagnosis of ADHD born between 1960 and 1998 in Sweden (N = 38,752). We obtained data for prescription of ADHD medication, diagnosis of depression and other psychiatric disorders, and sociodemographic factors from population-based registers. The association between ADHD medication and depression was estimated with Cox proportional hazards regression.

Results: After adjustment for sociodemographic and clinical confounders, ADHD medication was associated with a reduced long-term risk (i.e., 3 years later) for depression (hazard ratio = 0.58; 95% confidence interval, 0.51-0.67). The risk was lower for longer duration of ADHD medication. Also, ADHD medication was associated with reduced rates of concurrent depression; within-individual analysis suggested that occurrence of depression was 20% less common during periods when patients received ADHD medication compared with periods when they did not (hazard ratio = 0.80; 95% confidence interval, 0.70-0.92).

Conclusions: Our study suggests that ADHD medication does not increase the risk of later depression; rather, medication was associated with a reduced risk for subsequent and concurrent depression.

Keywords: ADHD medication; Cohort study; Depression; Long-term effect; Short-term effect; Stimulants.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenergic Uptake Inhibitors / adverse effects*
  • Adult
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Central Nervous System Stimulants / adverse effects*
  • Child
  • Depressive Disorder / chemically induced*
  • Depressive Disorder / epidemiology
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Registries / statistics & numerical data*
  • Risk
  • Sweden / epidemiology
  • Time Factors
  • Young Adult

Substances

  • Adrenergic Uptake Inhibitors
  • Central Nervous System Stimulants