Cumulative ADHD medication use and risk of type 2 diabetes in adults: a Swedish Register study

• Published in: BMJ mental health 2024, Vol.27 (1), p.e301195
• Main Authors: Dong, Zihan, Zhang, Le, Li, Lin, Liu, Shengxin, Brikell, Isabell, Kuja-Halkola, Ralf, D’Onofrio, Brian M, Butwicka, Agnieszka, Gudbjornsdottir, Soffia, Larsson, Henrik, Chang, Zheng, Du Rietz, Ebba
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult psychiatry; Aged; Atomoxetine Hydrochloride - adverse effects; Atomoxetine Hydrochloride - therapeutic use; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Blood pressure; Case-Control Studies; Central Nervous System Stimulants - adverse effects; Central Nervous System Stimulants - therapeutic use; Codes; Data Interpretation; Data Interpretation, Statistical; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Emigration; Female; Heart rate; Humans; Hyperactivity; Male; Medicin och hälsovetenskap; Methylphenidate - adverse effects; Methylphenidate - therapeutic use; Middle Aged; Original Research; Pharmacological Treatments; Prescriptions; PSYCHIATRY; Psykiatri; Registries; Risk Factors; Sociodemographics; Statistical; Sweden - epidemiology; Young Adult
• ISSN: 2755-9734; 2755-9734
• DOI: 10.1136/bmjment-2024-301195

BackgroundLittle is known about the impact of cumulative attention-deficit/hyperactivity disorder (ADHD) medication use on the risk of type 2 diabetes (T2D).ObjectiveThe objective is to examine the association between cumulative use of ADHD medication and risk of incident T2D.MethodsA nested case–control study was conducted in a national cohort of individuals aged 18–70 years with incident ADHD (n=138 778) between 2007 and 2020 through Swedish registers. Individuals with incident T2D after ADHD were selected as cases (n=2355) and matched with up to five controls (n=11 681) on age at baseline, sex and birth year. Conditional logistic regression models examined the association between cumulative duration of ADHD medication use and T2D.FindingsCompared with no use, a decreased risk of T2D was observed for those on cumulative use of ADHD medications up to 3 years (ORs: 03 years) use of atomoxetine was associated with an increased risk of T2D (OR: 1.44 (95% CI, 1.01 to 2.04)).ConclusionCumulative use of ADHD medication does not increase the risk for T2D, with the exception of long-term use of atomoxetine.Clinical implicationsFindings suggest that clinicians should be aware of the potential risk of T2D associated with the cumulative use of atomoxetine among patients with ADHD; however, further replication is strongly needed.