ADHD medication and unintentional injuries in children and adolescents

Objective: Our objective was to determine whether ADHD medication is associated with a decreased risk of unintentional injuries in children and adolescents in the United States across sexes, age groups and injury types. Methods: We used de-identified inpatient, outpatient, and filled prescription claims data from the Truven Health MarketScan® Research Databases. Individuals were followed from January 1, 2005, date of first ADHD diagnosis or medication prescription, or age 6, whichever occurred last, until December 31, 2014, first healthcare insurance disenrollment, or the first year at which their age was recorded as 19, whichever occurred first. A person was considered on ADHD medication during a given month if a prescription was filled in that month. The outcome was defined as emergency department visits for injuries, including traumatic brain injuries, with unintentional causes. Odds of having the outcome were compared between medicated and un-medicated months at the population-level and in within-individual analyses using logistic regression. Results: Among 1 968 146 individuals diagnosed with ADHD or receiving ADHD medication, 87 154 had at least one event. At the population-level, medication use was associated a lower risk of injuries, both in boys (OR= 0.85; 95% CI: 0.84–0.86) and girls (OR=0.87; 95% CI: 0.85–0.89). Similar results were obtained from within-individual analysis among male (OR= 0.72; 95% CI: 0.70–0.74) and female (OR= 0.72; 95% CI: 0.69–0.75) children, and among male (OR= 0.64; 95% CI: 0.60–0.67) and female (OR= 0.65; 95% CI: 0.60–0.71) adolescents. Similar results were found for traumatic brain injuries. Corresponding author: Laura Ghirardi, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, Stockholm 17177, Sweden, laura.ghirardi@ki.se, + 46 (0) 8 524 822 01. HHS Public Access Author manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2021 August 01. Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2020 August ; 59(8): 944–951. doi:10.1016/j.jaac.2019.06.010. A uhor M anscript