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

doi:10.1007/s00787-019-01283-y

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

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-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 language	English
Pages (from-to)	1213-1222
Number of pages	10
Journal	European child & adolescent psychiatry
Volume	28
Issue number	9
Early online date	5 Feb 2019
DOIs	https://doi.org/10.1007/s00787-019-01283-y
Publication status	Published - Sept 2019

Funding

This work was supported by National Institutes of Health Grant R01MH62873, Netherlands Organization for Scientific Research (NWO) Large Investment Grant 1750102007010, Netherlands organization for Health Research and Development (ZonMW) Priority Medicines for Children Grant 113202005, Netherlands Organization for Health Research and Development (ZonMW) grant 60-60600-97-193, Brain and Cognition grants 433-09-242 and 056-13-015, and grants from Radboud University Nijmegen Medical Center, University Medical Center Groningen and Accare, and Vrije Universiteit Amsterdam. Dr. Franke is supported by a Vici personal grant from the Netherlands Organization for Scientific Research (NWO) 016-130-669. The research of dr. Franke and dr. Buitelaar also receives funding from the European Community\u2019s Seventh Framework Programme (FP7/2007\u20132013), under grant agreements no. 278948 (TACTICS) and no. 602805 (Aggressotype), and from the European Community\u2019s Horizon 2020 Programme (H2020/2014\u20132020) under grant agreements no. 643051 (MiND), no. 667302 (CoCA), and no. 728018 (Eat2beNICE).

Funders	Funder number
Mind
Seventh Framework Programme
National Institutes of Health
Chiropractic and Osteopathic College of Australasia
European Community’s Horizon 2020 Programme
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	1750102007010, 056-13-015
Brain and Cognition	433-09-242
ZonMw	60-60600-97-193, 113202005
Horizon 2020 Framework Programme	667302, 278948, 643051, 728018
European Commission	602805
National Institute of Mental Health	R01MH062873
Radboud Universitair Medisch Centrum	016-130-669

Keywords

ADHD
Nicotine dependence
Stimulant medication
Substance use disorders

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00787-019-01283-y

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Groenman, A. P., Schweren, L. J. S., Weeda, W., Luman, M., Noordermeer, S. D. S., Heslenfeld, D. J., Franke, B., Faraone, S. V., Rommelse, N., Hartman, C. A., Hoekstra, P. J., Buitelaar, J., & Oosterlaan, J. (2019). Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder. European child & adolescent psychiatry, 28(9), 1213-1222. https://doi.org/10.1007/s00787-019-01283-y

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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 = sep,

doi = "10.1007/s00787-019-01283-y",

language = "English",

volume = "28",

pages = "1213--1222",

journal = "European child \& adolescent psychiatry",

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Groenman, AP, Schweren, LJS, Weeda, W, Luman, M , Noordermeer, SDS, Heslenfeld, DJ, Franke, B, Faraone, SV, Rommelse, N, Hartman, CA, Hoekstra, PJ, Buitelaar, J & Oosterlaan, J 2019, 'Stimulant treatment profiles predicting co-occurring substance use disorders in individuals with attention-deficit/hyperactivity disorder', European child & adolescent psychiatry, vol. 28, no. 9, pp. 1213-1222. https://doi.org/10.1007/s00787-019-01283-y

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 et al.
In: European child & adolescent psychiatry, Vol. 28, No. 9, 09.2019, p. 1213-1222.

Research output: Contribution to Journal › Article › Academic › peer-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 - 2019/9

Y1 - 2019/9

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

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M3 - Article

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SN - 1018-8827

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EP - 1222

JO - European child & adolescent psychiatry

JF - European child & adolescent psychiatry

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ER -

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

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Funding

Keywords

UN SDGs

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