by Karolinska Institutet

Credit: Unsplash/CC0 Public Domain

Researchers from Karolinska Institutet have shown a link between use of medication for ADHD and a reduced risk of premature death. The risk of death due to unnatural causes, such as accidents and overdoses, can be reduced by a quarter, according to the new study published in JAMA.

Previous research has shown that people diagnosed with ADHD have an increased risk of premature death. However, it is not clear whether medications for ADHD affect this risk.

A registry study followed nearly 150,000 Swedes aged 6-64, who were diagnosed with ADHD between 2007 and 2018. The researchers investigated the risk of death up to two years after diagnosis and compared those who started medication within three months of diagnosis (56.7 percent) with those who did not.

"The study showed that there is a link between initiation of medication and a lower risk of death. This was true regardless of the cause of death, but the risk of dying from unnatural causes, such as alcohol and drug overdose, decreased the most. The association was not as strong for the risk of dying from natural causes as physical health condition," says Lin Li, a postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet and first author of the study.

The risk of dying from unnatural causes was reduced by a quarter in the medicated group. As this is an observational study, it cannot establish a causal relationship, but the results suggest that early initiation of medication may be important for people with ADHD.

At the same time, there are other health aspects to consider when prescribing these medications. In an earlier study published in 2023 in JAMA Psychiatry, the same research team showed that there is also a link between ADHD medication and increased risk of hypertension and arterial diseases.

In the next step, they aim to explore the long-term effects of ADHD medication further.

"It will be crucial to establish whether the benefits we have seen in this study will persist over time. We will also try to identify any additional adverse effects associated with long-term medication," says Zheng Chang, a senior researcher at the Department of Medical Epidemiology and Biostatistics and the last author of the study.

The research team will also study the effects and mechanisms of different types of ADHD medications and how doses, duration of treatment, and sex differences may affect them.

"With such knowledge, doctors can tailor treatment plans for people with ADHD to maximize the benefits of treatment and minimize the risks," says Chang.

More information: Lin Li et al, ADHD Pharmacotherapy and Mortality in Individuals With ADHD, JAMA (2024). DOI: 10.1001/jama.2024.0851

Journal information: JAMA Psychiatry  , Journal of the American Medical Association 

Provided by Karolinska Institutet 

LGBT people can face unique skin health challenges

by Ernie Mundell

Gay and bisexual people, as well as those undergoing gender transition, could face unique dermatological issues, an expert says.

Board-certified dermatologist Dr. John Zampella, who runs a clinic in New York City that caters to many LGBTQ+ patients, said the risk for sexually transmitted infections is higher among this group and can sometimes lead to skin complications.

"Dermatologists are the experts in the diagnosis and treatment of many sexually transmitted infections like syphilis, HPV and herpes that often have skin-related symptoms," Zampella explained at the American Academy of Dermatology annual meeting in San Diego.

There are recent reports on the emergence of fungal infections, such as ringworm, that could also be sexually transmitted among gay and bisexual men.

These typically appear as a spreading rash in the groin or buttocks area, and should be examined by a physician such as a dermatologist, Zampella said. Strains of these infections often prove resistant to traditional antifungal meds and may take longer to treat.

The best way to stop many STIs is prevention, of course. As Zampella noted, pre-exposure prophylaxis (PrEP) antivirals are now available as injections that can provide users with two months of protection against HIV.

The U.S. Centers for Disease Control and Prevention has also approved the antibiotic doxycycline, taken within 72 hours of having sex, as a preventive measure against syphilis, chlamydia and gonorrhea.

Apart from STIs, transgender people often face the dermatological issues of acne and unwanted hair growth, Zampella noted.

"Acne in transgender individuals can be challenging to treat on your own because the cause is often a result of hormone therapy," Zampella noted in a meeting news release. "In these patients, the acne can be severe and the hormones lifelong, so these individuals often need the support of a dermatologist."

He said that in many cases isotretinoin (Accutane), can help clear patients of problem acne.

Hormonal and medication side effects can also bring on unwanted hair growth in transgender people, as well. According to Zampella, many dermatologists now include laser hair removal or electrolysis to help these patients.

"In many transgender women, hair on the face does not align with their gender identity and laser hair reduction is often sought," he explained. Results are often seen within six sessions.

In other cases, hair growth is desired.

"Hair growth is often a goal in transgender men and can be challenging to address," Zampella said. "While numerous hair loss treatments are available, dermatologists are finding that using therapies like oral minoxidil, a common blood pressure medication, are showing potential for improving hair growth."

"A board-certified dermatologist is not only able to develop individualized treatment plans that work for each patient but is also an effective partner who can help those seeking to align their gender identities," Zampella said.

More information: Find out more about STIs and their symptoms at the Cleveland Clinic.

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