Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder

Annabeth P. Groenman, Lizanne J.S. Schweren, Wouter Weeda, Marjolein Luman, Siri D.S. Noordermeer, Dirk J. Heslenfeld, Barbara Franke, Stephen V. Faraone, Nanda Rommelse, Catharina A. Hartman, Pieter J. Hoekstra, Jan Buitelaar, Jaap Oosterlaan

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of developing substance use disorders (SUDs) and nicotine dependence (ND). It remains unclear whether and how stimulant treatment may affect this risk. We aimed to investigate how stimulant use profiles influence the risk of SUDs and ND, using a novel data-driven community detection analysis to construct different stimulant use profiles. Comprehensive lifetime stimulant prescription data and data on SUDs and ND were available for 303 subjects with ADHD and 219 controls, with a mean age 16.3 years. Community detection was used to define subgroups based on multiple indicators of treatment history, start age, treatment duration, total dose, maximum dose, variability, stop age. In stimulant-treated participants, three subgroups with distinct medication trajectories were distinguished (late-and-moderately dosed, n = 91; early-and-moderately dosed, n = 51; early-and-intensely dosed, n = 103). Compared to stimulant-naïve participants (n = 58), the early-and-intense treatment group had a significantly lower risk of SUDs and ND (HR = 0.28, and HR = 0.29, respectively), while the early-and-moderate group had a significantly lower risk of ND only (HR = 0.30). The late-and-moderate group was at a significantly higher risk of ND compared to the other two treatment groups (HR = 2.66 for early-and-moderate, HR = 2.78 for early-and-intense). Our findings show that in stimulant-treated adolescents with ADHD, long-term outcomes are associated with treatment characteristics, something that is often ignored when treated individuals are compared to untreated individuals.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalEuropean child & adolescent psychiatry
DOIs
Publication statusE-pub ahead of print - 5 Feb 2019

Fingerprint

Tobacco Use Disorder
Attention Deficit Disorder with Hyperactivity
Substance-Related Disorders
Therapeutics
Prescriptions
History

Keywords

  • ADHD
  • Nicotine dependence
  • Stimulant medication
  • Substance use disorders

Cite this

Groenman, Annabeth P. ; Schweren, Lizanne J.S. ; Weeda, Wouter ; Luman, Marjolein ; Noordermeer, Siri D.S. ; Heslenfeld, Dirk J. ; Franke, Barbara ; Faraone, Stephen V. ; Rommelse, Nanda ; Hartman, Catharina A. ; Hoekstra, Pieter J. ; Buitelaar, Jan ; Oosterlaan, Jaap. / Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder. In: European child & adolescent psychiatry. 2019 ; pp. 1-10.
@article{aa51567adcdb4ccaa215cb2676b9778b,
title = "Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder",
abstract = "Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of developing substance use disorders (SUDs) and nicotine dependence (ND). It remains unclear whether and how stimulant treatment may affect this risk. We aimed to investigate how stimulant use profiles influence the risk of SUDs and ND, using a novel data-driven community detection analysis to construct different stimulant use profiles. Comprehensive lifetime stimulant prescription data and data on SUDs and ND were available for 303 subjects with ADHD and 219 controls, with a mean age 16.3 years. Community detection was used to define subgroups based on multiple indicators of treatment history, start age, treatment duration, total dose, maximum dose, variability, stop age. In stimulant-treated participants, three subgroups with distinct medication trajectories were distinguished (late-and-moderately dosed, n = 91; early-and-moderately dosed, n = 51; early-and-intensely dosed, n = 103). Compared to stimulant-na{\"i}ve participants (n = 58), the early-and-intense treatment group had a significantly lower risk of SUDs and ND (HR = 0.28, and HR = 0.29, respectively), while the early-and-moderate group had a significantly lower risk of ND only (HR = 0.30). The late-and-moderate group was at a significantly higher risk of ND compared to the other two treatment groups (HR = 2.66 for early-and-moderate, HR = 2.78 for early-and-intense). Our findings show that in stimulant-treated adolescents with ADHD, long-term outcomes are associated with treatment characteristics, something that is often ignored when treated individuals are compared to untreated individuals.",
keywords = "ADHD, Nicotine dependence, Stimulant medication, Substance use disorders",
author = "Groenman, {Annabeth P.} and Schweren, {Lizanne J.S.} and Wouter Weeda and Marjolein Luman and Noordermeer, {Siri D.S.} and Heslenfeld, {Dirk J.} and Barbara Franke and Faraone, {Stephen V.} and Nanda Rommelse and Hartman, {Catharina A.} and Hoekstra, {Pieter J.} and Jan Buitelaar and Jaap Oosterlaan",
year = "2019",
month = "2",
day = "5",
doi = "10.1007/s00787-019-01283-y",
language = "English",
pages = "1--10",
journal = "European Child and Adolescent Psychiatry",
issn = "1018-8827",
publisher = "D. Steinkopff-Verlag",

}

Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder. / Groenman, Annabeth P.; Schweren, Lizanne J.S.; Weeda, Wouter; Luman, Marjolein; Noordermeer, Siri D.S.; Heslenfeld, Dirk J.; Franke, Barbara; Faraone, Stephen V.; Rommelse, Nanda; Hartman, Catharina A.; Hoekstra, Pieter J.; Buitelaar, Jan; Oosterlaan, Jaap.

In: European child & adolescent psychiatry, 05.02.2019, p. 1-10.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder

AU - Groenman, Annabeth P.

AU - Schweren, Lizanne J.S.

AU - Weeda, Wouter

AU - Luman, Marjolein

AU - Noordermeer, Siri D.S.

AU - Heslenfeld, Dirk J.

AU - Franke, Barbara

AU - Faraone, Stephen V.

AU - Rommelse, Nanda

AU - Hartman, Catharina A.

AU - Hoekstra, Pieter J.

AU - Buitelaar, Jan

AU - Oosterlaan, Jaap

PY - 2019/2/5

Y1 - 2019/2/5

N2 - Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of developing substance use disorders (SUDs) and nicotine dependence (ND). It remains unclear whether and how stimulant treatment may affect this risk. We aimed to investigate how stimulant use profiles influence the risk of SUDs and ND, using a novel data-driven community detection analysis to construct different stimulant use profiles. Comprehensive lifetime stimulant prescription data and data on SUDs and ND were available for 303 subjects with ADHD and 219 controls, with a mean age 16.3 years. Community detection was used to define subgroups based on multiple indicators of treatment history, start age, treatment duration, total dose, maximum dose, variability, stop age. In stimulant-treated participants, three subgroups with distinct medication trajectories were distinguished (late-and-moderately dosed, n = 91; early-and-moderately dosed, n = 51; early-and-intensely dosed, n = 103). Compared to stimulant-naïve participants (n = 58), the early-and-intense treatment group had a significantly lower risk of SUDs and ND (HR = 0.28, and HR = 0.29, respectively), while the early-and-moderate group had a significantly lower risk of ND only (HR = 0.30). The late-and-moderate group was at a significantly higher risk of ND compared to the other two treatment groups (HR = 2.66 for early-and-moderate, HR = 2.78 for early-and-intense). Our findings show that in stimulant-treated adolescents with ADHD, long-term outcomes are associated with treatment characteristics, something that is often ignored when treated individuals are compared to untreated individuals.

AB - Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of developing substance use disorders (SUDs) and nicotine dependence (ND). It remains unclear whether and how stimulant treatment may affect this risk. We aimed to investigate how stimulant use profiles influence the risk of SUDs and ND, using a novel data-driven community detection analysis to construct different stimulant use profiles. Comprehensive lifetime stimulant prescription data and data on SUDs and ND were available for 303 subjects with ADHD and 219 controls, with a mean age 16.3 years. Community detection was used to define subgroups based on multiple indicators of treatment history, start age, treatment duration, total dose, maximum dose, variability, stop age. In stimulant-treated participants, three subgroups with distinct medication trajectories were distinguished (late-and-moderately dosed, n = 91; early-and-moderately dosed, n = 51; early-and-intensely dosed, n = 103). Compared to stimulant-naïve participants (n = 58), the early-and-intense treatment group had a significantly lower risk of SUDs and ND (HR = 0.28, and HR = 0.29, respectively), while the early-and-moderate group had a significantly lower risk of ND only (HR = 0.30). The late-and-moderate group was at a significantly higher risk of ND compared to the other two treatment groups (HR = 2.66 for early-and-moderate, HR = 2.78 for early-and-intense). Our findings show that in stimulant-treated adolescents with ADHD, long-term outcomes are associated with treatment characteristics, something that is often ignored when treated individuals are compared to untreated individuals.

KW - ADHD

KW - Nicotine dependence

KW - Stimulant medication

KW - Substance use disorders

UR - http://www.scopus.com/inward/record.url?scp=85061188481&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061188481&partnerID=8YFLogxK

U2 - 10.1007/s00787-019-01283-y

DO - 10.1007/s00787-019-01283-y

M3 - Article

SP - 1

EP - 10

JO - European Child and Adolescent Psychiatry

JF - European Child and Adolescent Psychiatry

SN - 1018-8827

ER -