From the Guidelines
Individuals with Attention Deficit Hyperactivity Disorder (ADHD) have a shorter life expectancy due to a combination of factors, including a higher incidence of comorbid conditions, poor medication adherence, and impulsivity-related risk-taking behaviors.
Key Factors Contributing to Reduced Life Expectancy
- Comorbid conditions: Such as substance abuse and cardiovascular disease, which may be exacerbated by poor medication adherence to stimulant medications like methylphenidate and amphetamine 1.
- Impulsivity and risk-taking behaviors: Associated with ADHD, contributing to increased mortality rates due to accidents, injuries, and other external causes, as seen in teen drivers with ADHD who are 2 to 4 times more likely to be injured in a motor vehicle crash than their peers without ADHD 1.
- Treatment discontinuation: Places individuals with ADHD at higher risk for catastrophic outcomes, such as motor vehicle crashes, criminality, depression, and other injuries 1.
Impact of Comorbid Conditions
Comorbid conditions, such as substance use disorders and anxiety, can increase the risk of suicide and worsen treatment outcomes in individuals with ADHD, highlighting the need for comprehensive and multidisciplinary treatment approaches 1.
Importance of Medication Adherence and Treatment
Medication adherence and treatment can help mitigate the risks associated with ADHD, and optimizing pharmacological treatment using evidence-based algorithms and guidelines is recommended to promote response and remission, and reduce severity of symptoms commonly associated with risky behaviors 1.
From the FDA Drug Label
5 WARNINGS AND PRECAUTIONS
- 2 Risks to Patients with Serious Cardiac Disease Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who were treated with CNS stimulants at the recommended ADHD dosage
The FDA drug label does not directly answer the question of why individuals with ADHD have a shorter life expectancy. However, it does mention that sudden death has been reported in patients with serious cardiac disease who were treated with CNS stimulants, including methylphenidate, at the recommended ADHD dosage.
- This information suggests a potential increased risk of cardiac-related mortality in patients with pre-existing cardiac conditions.
- However, it does not provide a direct explanation for the shorter life expectancy in individuals with ADHD. 2
From the Research
Background on ADHD and Mortality
- Individuals with Attention Deficit Hyperactivity Disorder (ADHD) have been found to have a higher risk of premature death compared to those without ADHD 3, 4, 5.
- The mortality rate per 10,000 person-years was found to be higher in individuals with ADHD, with accidents being the most common cause of death 3.
- A study found that the odds of dying are significantly higher among those with ADHD than among those without ADHD, with accidental death being more common among those with ADHD 5.
Factors Contributing to Increased Mortality in ADHD
- Unnatural causes of death, such as accidents, unintentional injuries, and suicide, are more common in individuals with ADHD 3, 4, 5.
- Comorbid conditions, such as oppositional defiant disorder, conduct disorder, and substance use disorder, can increase the mortality risk in individuals with ADHD 3.
- Subthreshold levels of childhood ADHD symptoms were not found to be associated with increased mortality 4.
Impact of ADHD Medication on Mortality
- Initiation of ADHD medication has been associated with significantly lower all-cause mortality, particularly for death due to unnatural causes 6.
- Stimulants have been found to be associated with a lower risk of all-cause mortality and reduced risk of unintentional injuries 7.
- Non-stimulants and concomitant use of stimulants and non-stimulants have been associated with reduced risk of unintentional injuries, but not all-cause mortality 7.