Psychotropic and Somatic Medication Use in Adults with Childhood ADHD, their Siblings, and Controls: A Prospective Long-Term Longitudinal Study

Background. Adults with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood show higher healthcare utilization, but their medication use remains understudied while this can clarify the long-term health burden of childhood ADHD. Methods. In this 18-year prospective cohort study, pharmacy dispensing records of ADHD, other psychotropic, and somatic medication of the last year were compared between adults with childhood ADHD (n=125, Mage=29, 68% males), their siblings (n=109, Mage=28, 35% males) and controls (n=101, Mage=30, 42% males) without childhood ADHD at study entry. Group differences in demographics and psychiatric status were included as covariates (sensitivity analyses). Results. The childhood ADHD group was more likely to be prescribed ADHD medication, more different ADHD medications, non-steroidal anti-inflammatory drugs (NSAIDs), and neurological medications (specifically analgesics) compared to their siblings and controls (OR range=3.25-8.35, β range=0.61-0.65). Compared to controls, the childhood ADHD group was also more likely to be prescribed other psychotropic medication (OR=3.82) and used more different types of psychotropic medication (β=0.38). Siblings and controls did not differ. Findings remained after controlling for demographic differences, except that the childhood ADHD group no longer differed from controls on analgesics. After controlling for psychiatric status differences (ADHD, major depressive disorder), the childhood ADHD group still differed on ADHD medication use, more different ADHD medications, and NSAIDs, and from controls on more different psychotropic medications. Conclusions. Adults with childhood ADHD, but not their siblings, show elevated long-term medication use. The elevated medication use is not merely explained by shared familial factors but is partly attributable to current psychiatric status.