Association of Risk of Suicide Attempts With Methylphenidate Treatment

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Man KKC, Coghill D, Chan EW, Lau WCY, Hollis C, Liddle E, Banaschewski T, Mccarthy S, Neubert A, Sayal K, Ip P, Schuemie MJ, Sturkenboom MCJM, Sonuga-Barke E, Buitelaar J, Carucci S, Zuddas A, Kovshoff H, Garas P, Nagy P, Inglis SK, Konrad K, Hage A, Rosenthal E, Wong ICK
Zeitschrift: JAMA Psychiatry
Jahr der Veröffentlichung: 2017
Band: 74
Heftnummer: 10
Seitenbereich: 1048-1055
ISSN: 2168-622X
eISSN: 2168-6238


Abstract

Importance: Patients with attention-deficit/hyperactivity disorder (ADHD) are at an increased risk of attempting suicide. Stimulants, such as methylphenidate hydrochloride, are the most common treatment for ADHD, but the association between their therapeutic use and suicide is unclear.
Objective: To investigate the association between methylphenidate and the risk of suicide attempts.
Design, Setting, and Participants: A population-based, electronic medical records database from the Hong Kong Clinical Data Analysis & Reporting System was used to identify 25 629 individuals aged 6 to 25 years who were treated with methylphenidate between January 1, 2001, and December 31, 2015. Those who had attempted suicide were included in the analysis. A self-controlled case series design was used to control for time-invariant characteristics of the patients.
Main Outcomes and Measures: Relative incidence of suicide attempt during periods when patients were exposed to methylphenidate compared with nonexposed periods.
Results: Among 25 629 patients with methylphenidate prescriptions, 154 had their first recorded suicide attempt within the study period; of these individuals, 111 (72.1%) were male; mean (SD) age at baseline was 7.15 (2.19) years. The overall incidence of suicide attempts during methylphenidate treatment was 9.27 per 10 000 patient-years. An increased risk of suicide attempts was detected during the 90-day period before methylphenidate was initiated, with an incidence rate ratio (IRR) of 6.55 (95% CI, 3.37-12.72). The IRR remained elevated during the first 90 days of treatment (IRR, 3.91; 95% CI, 1.62-9.42) before returning to baseline levels during ongoing treatment (IRR, 1.35; 95% CI, 0.77-2.38). When the risk during the first 90 days of treatment was compared with the 90 days preceding first treatment, the incidence of suicide attempts was not elevated (IRR, 0.78; 95% CI, 0.26-2.35).
Conclusions and Relevance: The incidence of suicide attempts was higher in the period immediately before the start of methylphenidate treatment. The risk remained elevated immediately after the start of methylphenidate treatment and returned to baseline levels during continuation of methylphenidate treatment. The observed higher risk of suicide attempts before treatment may reflect emerging psychiatric symptoms that trigger medical consultations that result in a decision to begin ADHD treatment. Therefore, this study's results do not support a causal association between methylphenidate treatment and suicide attempts.


FAU-Autoren / FAU-Herausgeber

Neubert, Antje Prof. Dr.
Kinder- und Jugendklinik


Autor(en) der externen Einrichtung(en)
Erasmus University Rotterdam (EUR) / Erasmus Universiteit Rotterdam
Evelina London Children's Hospital
Janssen Pharmaceutica NV
Radboud university medical center / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC)
Ruprecht-Karls-Universität Heidelberg
Università degli Studi di Cagliari
Universitätsklinikum Aachen
University College Cork (UCC)
University College London (UCL) (University of London)
University of Dundee
University of Hong Kong (HKU) / 香港大學
University of Nottingham
University of Southampton
VADASKERT Child and Adolescent Psychiatry Hospital and Outpatient Clinic


Zitierweisen

APA:
Man, K.K.C., Coghill, D., Chan, E.W., Lau, W.C.Y., Hollis, C., Liddle, E.,... Wong, I.C.K. (2017). Association of Risk of Suicide Attempts With Methylphenidate Treatment. JAMA Psychiatry, 74(10), 1048-1055. https://dx.doi.org/10.1001/jamapsychiatry.2017.2183

MLA:
Man, Kenneth K. C., et al. "Association of Risk of Suicide Attempts With Methylphenidate Treatment." JAMA Psychiatry 74.10 (2017): 1048-1055.

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Zuletzt aktualisiert 2018-13-11 um 10:08