Treatment with Methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) and the Risk of All-Cause Poisoning in Children and Adolescents: A Self-Controlled Case Series Study
| Autor: | Kenneth K.C. Man, Esther W. Chan, Kam Lun Hon, Celine S L Chui, David Coghill, Ian C. K. Wong, Le Gao, ML Tse, Kirstie H. T. W. Wong, Xue Li, Patrick Ip, Terry Y. S. Lum |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Medication Therapy Management Subgroup analysis Lower risk Risk Assessment Risk Factors Medicine Attention deficit hyperactivity disorder Humans Pharmacology (medical) Original Research Article Medical prescription Child business.industry Methylphenidate Incidence Poisoning medicine.disease Confidence interval Psychiatry and Mental health Attention Deficit Disorder with Hyperactivity Accidental Hong Kong Central Nervous System Stimulants Female Risk Adjustment Neurology (clinical) business Case series medicine.drug |
| Zdroj: | CNS Drugs |
| ISSN: | 1179-1934 |
| Popis: | Background Children and adolescents with attention deficit hyperactivity disorder (ADHD) are at higher risk of all-cause poisoning by drugs and chemicals (intentional or accidental). Currently, there is limited data on whether medication treatment for ADHD can reduce the risk of all-cause poisoning. Methods Patients aged 5–18 years with a methylphenidate (MPH) prescription and an incident poisoning diagnosis between January 2001 and June 2020 were identified from the Hong Kong Clinical Data Analysis and Reporting System. A self-controlled case series study design was used to compare the incidence rate ratios (IRRs) of all-cause poisoning during different risk windows (30 days before the first MPH prescription, exposure periods within 30 days of the first prescription, and periods of subsequent exposure) compared with the reference window (other non-exposure periods). Results 42,203 patients were prescribed ADHD medication in Hong Kong during the study period. Of these, 417 patients who had both an MPH prescription and poisoning incident recorded were included in the main analysis. Compared with other non-exposed periods, a higher risk of poisoning was found in the 30 days before the first prescription (IRR 2.64, 95% confidence interval [CI] 1.33–5.22) and exposure periods within 30 days of the first prescription (IRR 2.18, 95% CI 1.06–4.48), but not during prolonged exposure. However, compared with 30 days before the first prescription as well as exposure periods within 30 days of the first prescription, there was a lower risk during the subsequent exposure (IRRs 0.49 and 0.60, respectively). Similar results to the main analysis were also found in the subgroup analysis of intentional poisoning and females, but not in that of accidental poisoning and males. Conclusions The risk of all-cause poisoning was higher shortly before and after the first MPH prescription and became lower during the subsequent prescription period. Our results do not support an association between the use of MPH and an increased risk of all-cause poisoning in children and adolescents and, in fact, suggest that longer-term use of MPH may be associated with a lower risk of all-cause poisoning, although this latter finding requires further study. Supplementary Information The online version contains supplementary material available at 10.1007/s40263-021-00824-x. |
| Databáze: | OpenAIRE |
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