Continued use of ADHD drugs may reduce criminal behavior, study says

Males with ADHD who stayed on medications for the disorder reduced their risk of criminal behavior by 32 percent, while women who did so reduced their rates of criminal behavior by 42 percent, according to a large Swedish study.

"It seems as though ADHD medications decrease the risk for criminality while under treatment," said the study's lead author, Paul Lichtenstein, professor of genetic epidemiology at the Karolinska Institute, in Stockholm.

Results of the study are published in the Nov. 22 issue of the New England Journal of Medicine.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park, said past research has found that adults with ADHD have a "host of increased risks later in life, like driving accidents, losing jobs, divorce and arrests." Adesman said those at greatest risk of criminal behavior are those with hyperactivity.

Adesman added that it's important for parents to know that not all children with ADHD will engage in criminal behavior, and that some children will outgrow ADHD. Still, "collectively, people with ADHD are at risk for a range of poor outcomes," he said.

For the current study, the researchers gathered information on more than 25,000 people living in Sweden with a diagnosis of ADHD. They also collected information on what types of medications were given as treatment, and any criminal convictions that occurred between 2006 and 2009.

Researchers then compared non-medication periods to medication periods and the rates of criminal behavior for each person.

The risk of criminal activity dropped by more than a third for men and women combined during medication periods, according to the study.

Lichtenstein said the researchers didn't study whether medications were more effective in reducing criminal behavior for a particular age group. They also didn't look at whether one type of medication was better at decreasing the risk of criminal activity, but he said those that influence the core symptoms of ADHD—such as impulsivity, restlessness and irritability—are likely to be better at reducing criminal behavior.

Lichtenstein said ADHD medications should be seriously considered for adolescents and young adults with ADHD who are at risk for criminal behavior.

"All medications have potential adverse side effects, and the clinician should weigh risks and benefits for each patient," he added. "Now, they should include the potential decreased risk of criminality in that evaluation."

For his part, Adesman said that based on the findings of this study, it looks as though treatment with ADHD medication can make a difference in the risk of criminal behavior. But, he said, it's important to realize that the population in this study isn't the same as the population in the United States, so the findings might be different if the study were done here.

Adesman said it is also important not to "presume that children diagnosed with ADHD today have the same risks of criminality as people diagnosed 20 years ago, given the greater awareness, education resources and support that is available today."

However, he added, "I suspect that symptomatic people probably do better with medications."

Although the study found an association between staying on ADHD medication and reduced criminal behavior, it did not prove a cause-and-effect relationship.

More information: Learn more about the medications used to treat ADHD from the U.S. National Institute of Mental Health.

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Journal reference: New England Journal of Medicine

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