ADHD Medication Linked to Fewer ER Visits

Youth taking Ritalin are 9 percent less likely to go to ER for trauma.

Posted Feb 20, 2015

Children who meet criteria for ADHD are known to be prone to injuries and accidents.  From running into the street impulsively to traffic accidents, these injuries can range from minor to devastating.  What is less known is whether ADHD treatment can reduce this frequency. 

A new study, however, tries to look directly at this question.  The study's authors utilized a large electronic database of health care information for patients living in Hong Kong.  Their focus was on visits to the emergency department (ED) admissions for traumatic related injuries between 2001 and 2013.  The subjects were over 17,000 youth between the ages of 6 to 19 who at one time were prescribed methylphenidate.  The primary comparison was the frequency of ED visits during the time a child was being prescribed the ADHD medication methylphenidate (Ritalin) compared to times when the same child was not taking medication.  The authors also checked admission rates for ED visits not related to trauma as a control for their hypothesis, under the prediction that methylphenidate would have no association in these cases. 

Overall, they found that approximately 28 percent of children in the study had a trauma-related ED admission during the study period. The rate of an ED visit for a traumatic injury during times children were being prescribed methylphenidate was significantly lower in comparison to the period when the child was not prescribed methylphenidate.  The amount of reduction was modest at around 9 percent (although remember that these were just for injuries serious enough to require an ED). The reduction was found for both girls and boys and was particularly strong for older adolescents, where an impressive 32 percent reduction was found.  Bolstering confidence that this might be a real effect was the fact that this reduction was not found when looking at ED admissions for non-traumatic injuries.

The authors concluded that they were able to detect a protective association for methylphenidate related to traumatic injuries resulting in emergency department visits. The authors suggest that this factor be taken into account when deciding about treatment.

It should be noted that several of the authors did have financial ties to the pharmaceutical industry.  In my book, that means that I tend to lend a more skeptical eye to research supporting medication use but doesn’t mean I dismiss it out of hand. 

Furthermore, lest anyone think that this post is all about advocating just for medications, I also can’t help but make reference to a similar study done in 2005 in England that showed an association between decreased ED visits for trauma and the release dates of two Harry Potter novels.   

@copyright by David Rettew, MD

David Rettew is author of Child Temperament: New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College of Medicine.

Follow him at @PediPsych and like PediPsych on Facebook.