Methylphenidate and the risk of trauma

Kenneth K. C. Man, Esther W. Chan, David Coghill, Ian Douglas, Patrick Ip, Ling-Pong Leung, Matthew S. H. Tsui, Wilfred H. S. Wong, Ian C. K. Wong

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    Abstract

    BACKGROUND AND OBJECTIVE: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are prone to sustaining trauma that requires emergency department (ED) admission. Methylphenidate (MPH) can reduce ADHD symptoms and may thus theoretically reduce the risk of trauma-related ED admission, but previous studies do not make this association clear. This study examines this association.

    METHODS: A total of 17 381 patients aged 6 to 19 years who received MPH prescriptions were identified by using the Clinical Data Analysis & Reporting System (2001-2013). Using a self-controlled case series study design, the relative incidence of trauma-related ED admissions was compared with periods of patient exposure and nonexposure to MPH.

    RESULTS: Among 17 381 patients prescribed MPH, 4934 had at least 1 trauma-related ED admission. The rate of trauma-related ED admission was lower during exposed periods compared with nonexposed periods (incidence rate ratio [IRR]: 0.91 [95% confidence interval (CI): 0.86-0.97]). The findings were similar only when the incident trauma episode was assessed (IRR: 0.89 [95% CI: 0.82-0.96]). A similar protective association was found in both genders. In validation analysis using nontrauma-related ED admissions as a negative control outcome, no statistically significant association was found (IRR: 0.99 [95% CI: 0.95-1.02]). All sensitivity analyses demonstrated consistent results.

    CONCLUSIONS: This study supports the hypothesis that MPH is associated with a reduced risk of trauma-related ED admission in children and adolescents. A similar protective association was found in both male and female patients. This protective association should be considered in clinical practice.

    Original languageEnglish
    Pages (from-to)40-48
    Number of pages9
    JournalPediatrics
    Volume135
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2015

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  • Cite this

    Man, K. K. C., Chan, E. W., Coghill, D., Douglas, I., Ip, P., Leung, L-P., Tsui, M. S. H., Wong, W. H. S., & Wong, I. C. K. (2015). Methylphenidate and the risk of trauma. Pediatrics, 135(1), 40-48. https://doi.org/10.1542/peds.2014-1738