🧠 ADHD Medication and Life Risks: What a Swedish Study Found

August 24 2025

Citation:

Zhang, L., Zhu, N., Sjölander, A., Nourredine, M., Li, L., Garcia-Argibay, M., Kuja-Halkola, R., Brikell, I., Lichtenstein, P., D’Onofrio, B. M., Larsson, H., Cortese, S., & Chang, Z. (2025). ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials. BMJ, 390, e083658. https://doi.org/10.1136/bmj-2024-083658

📌 Why this study was done

ADHD is not just about attention and focus. It’s linked to higher risks of:

• Suicidal behaviors
• Substance misuse (alcohol, drugs)
• Accidental injuries
• Transport accidents (like car crashes)
• Criminal convictions

Researchers wanted to know if ADHD medication lowers these risks in real-world patients, not just in clinical trials.

🔎 Who was studied

• 148,581 people with ADHD in Sweden, aged 6–64.
• Followed for two years after diagnosis.
• Compared those who started ADHD medication within 3 months vs. those who did not.
• Data came from Swedish national health, crime, and prescription registers.

✨ Key Findings

1. Lower risk of serious outcomes with ADHD medication

People who took ADHD meds had significantly lower risks for:

• Suicidal behaviors: 17% lower risk
• Substance misuse: 15% lower risk
• Transport accidents: 12% lower risk
• Criminal convictions: 13% lower risk
• Accidental injuries: No significant reduction for the first injury, but repeat injuries were reduced.

2. Even stronger effects for people with prior struggles

• For those with a history of self-harm, substance misuse, or criminality, ADHD medication reduced risks more sharply.
• This suggests that people who are most vulnerable may benefit the most.

3. Stimulants worked better than non-stimulants

• Stimulants (like methylphenidate, dexamphetamine, lisdexamfetamine) had stronger protective effects than non-stimulants (like atomoxetine or guanfacine).
• This supports guidelines that recommend stimulants as the first-line treatment.

4. Differences by age and sex

• Adults saw stronger reductions in substance misuse and criminality.
• Children/teens showed stronger protection against repeat suicidal behaviors.
• Women with ADHD had slightly greater reductions in criminality compared to men.

🌱 Why this matters

• ADHD medication isn’t only about managing focus — it may also protect against life-threatening and high-risk outcomes.
• Benefits are clearest for people with prior problems, but extend across all age groups.
• Stimulant medications seem to provide the most protection overall.
• For families and patients, this shows that treatment can have broad safety and quality-of-life benefits, not just symptom control.