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Systematic Review of Suicidal Behaviors Related to Methylphenidate and Atomoxetine in Patients With Attention Deficit Hyperactivity Disorder

  • Jae Heon Kim (Department of Urology, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University) ;
  • Suyeon Park (Department of Biostatistics, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University) ;
  • Yeon Jung Lee (Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Soonchunhyang University)
  • Received : 2022.11.28
  • Accepted : 2022.12.19
  • Published : 2023.04.01

Abstract

Objectives: This study investigated the relationship between suicidal behavior and the use of methylphenidate (MPH) or atomoxetine (ATX) in patients with attention deficit hyperactivity disorder (ADHD). Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to conduct a meta-analysis. The Physiotherapy Evidence Database scale was used to score the quality of the studies. Results: Nine studies were included in this quantitative analysis. The analysis included 602864 patients with ADHD (521125 and 81739 patients were taking methylphenidate [MPH group] and atomoxetine [ATX group], respectively) and 19230 healthy controls. The overall estimates were in the order of the control, MPH, and ATX groups; however, no statistically significant between-group difference was observed in the incidence of events (p=0.553 for control vs. MPH; p=1.000 for control vs. ATX; p=1.000 for MPH vs. ATX). Conclusion: The rate of suicidal behavior was higher in the ADHD groups treated with MPH and ATX than in the control group. However, no statistically significant difference was observed between the ADHD groups treated with MPH and ATX, and the control group. Therefore, MPH and ATX did not increase suicidal behavior.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant, the Korea government (MSIT; grant number 2020R1F1A1048211), and the Soonchunhyang University Research Fund.

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