Effect of prior stimulant treatment for attention-deficit/hyperactivity disorder on subsequent risk for cigarette smoking and alcohol and drug use disorders in adolescents - PubMed (original) (raw)

Comparative Study

Effect of prior stimulant treatment for attention-deficit/hyperactivity disorder on subsequent risk for cigarette smoking and alcohol and drug use disorders in adolescents

Timothy E Wilens et al. Arch Pediatr Adolesc Med. 2008 Oct.

Abstract

Objective: To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD).

Design: Case-controlled, prospective, 5-year follow-up study.

Setting: Massachusetts General Hospital, Boston.

Participants: Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD.

Main outcome measures: We modeled time to onset of SUDs and smoking as a function of stimulant treatment.

Results: We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; chi(2)(113) = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; chi(2)(111) = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD.

Conclusion: Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD.

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Figures

Figure 1

Figure 1

The effects of prior stimulant exposure on risk for a subsequent substance use disorder (SUD; curves truncated at 18 years).

Figure 2

Figure 2

The effects of prior stimulant exposure on risk for a subsequent cigarette smoking (dependence; curves truncated at 18 years).

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References

    1. Kessler RC, et al. The prevalence and correlates of adult ADHD in the United States: Results from the national comorbidity survey replication. American Journal of Psychiatry. 2006;163(4):716–723. - PMC - PubMed
    1. Faraone SV, et al. The Worldwide Prevalence of ADHD: Is it an American Condition? World Psychiatry. 2003;2(2):104–113. - PMC - PubMed
    1. Polanczyk G, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942–8. - PubMed
    1. Hinshaw SP. Preadolescent girls with attention-deficit/hyperactivity disorder: I. Background characteristics, comorbidity, cognitive, and social functioning, and parenting practices. J Consult Clin Psych. 2002;70(5):1086–1098. - PubMed
    1. Biederman J, et al. Psychopathology in females with attention-deficit/hyperactivity disorder: A controlled, five-year prospective study. Biological Psychiatry. 2006;60(10):1098–105. - PubMed

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