ADHD

Updated 13 June 2017

Do ADHD medications really increase the risk of suicide?

Researchers from Montreal believe that suicide warnings on ADHD medications are misleading and may cause confusion in those diagnosed with the condition.

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Health officials in Canada have warned that ADHD medications may carry an increased risk of suicide; however Montreal researchers argue that medications may actually reduce the suicide rates.

Series of black-box warnings

Black-box warnings about the dangers of attention-deficit hyperactivity disorder (ADHD) medications are confusing and could have serious consequences for the risk of youth suicide, according to researchers at the Institut universitaire en santé mentale de Montréal (CIUSSS de l'Est-de-l'Île-de-Montréal) and the University of Montreal, whose correspondence has just been published in the most recent issue of the journal The Lancet Psychiatry.

"Health Canada has issued a series of black-box warnings about the suicidal potential of ADHD medications. However, these warnings have failed to take into account epidemiological studies showing the opposite, that increased use of this medication has been associated with reduced suicide risk in adolescents," says Dr Alain Lesage, psychiatrist and researcher at the Institut universitaire en santé mentale de Montréal (CIUSSS de l'Est-de-l'Île-de-Montréal) and one of study's authors.

In the past decade, the medical treatment of ADHD increased three-fold in Quebec, reaching 9% of boys aged 10 years and 4% of boys aged 15 years. However, suicide rates in Quebec's adolescents decreased by nearly 50% during that period among 15-19 year olds, which contradicts the warnings issued by Health Canada.

"Clearly, the increased use of ADHD drugs indicates that they might actually reduce rather than augment the risk of suicide," says Edouard Kouassi, pharmacist and researcher at the Institut universitaire en santé mentale de Montréal (CIUSSS de l'Est-de-l'Île-de-Montréal) and co-author of the study.

Read: Experts call for suicide risk warnings on ADHD medications

How can this decrease be explained clinically?

"Randomised controlled trials have shown ADHD medication to alleviate the usual symptoms of hyperactivity and attention deficit. It has also been associated with improvements in school performance, better self-esteem, and reductions in conduct disorders, drug abuse, and pregnancies in girls.

In fact, these disorders or precarious social situations are especially associated with increased risk of suicide, not the actual taking of these drugs, which, on the contrary, may prevent suicide," say the authors.

Indeed, Health Canada's black-box warming may contribute to reducing prescriptions because of parents' fears about their children's health, while these medications may actually protect them.

"The silence from the Public Health Agency of Canada (PHAC) is especially worrying in a context in which it has been called on to prepare a national suicide prevention strategy for the government of Canada under Bill C-300. We wrote this correspondence hoping to sound the alarm about the warnings published by Quebec's health authorities, as elsewhere in Canada, which might lead to a decrease in this effective medical treatment," they conclude.

Read more:

Side effects of ADHD medication

Poor sleep linked to depression and ADHD in kids

ADHD linked to earlier use of illicit drugs in kids

EurekAlert

 

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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