Zinabu Samrawit, Gasmelseed Huda, Wheaton Noah, Girma Fikirte, Wong Christian, Tabraiz Sair Ahmad, Mubasher Ayesha, Mack Aaron, Lexima Patrice, Qazi Ozair, Mohammed Ahmad, Sood Aseem, Michael Miriam
Department of Internal Medicine, Howard University, Washington, DC, United States.
Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia.
Front Psychiatry. 2024 Dec 20;15:1509385. doi: 10.3389/fpsyt.2024.1509385. eCollection 2024.
Attention Deficit Hyperactivity Disorder (ADHD), a prevalent neurodevelopmental disorder affecting a significant portion of the population, is commonly managed with stimulant medications. These medications, while effective, have been associated with thermoregulatory dysfunction and an increased risk of heat-related adverse events. The current study sought to compare the incidence of such events in ADHD patients receiving stimulant medications with those not on these treatments.
A retrospective cohort study was conducted utilizing de-identified electronic medical records from a Global Research Network. The study population comprised ADHD patients on stimulant medication aged 6-24 years, with a comparison group of ADHD patients not receiving stimulant medications. Patients were followed from the date of first cohort inclusion (index event) for one year to track heat-related illnesses, including dehydration, hyperthermia, heat stroke, and other heat-related conditions. Propensity score matching was employed to balance baseline characteristics (age, gender) between cohorts. Risk ratios, odds ratios, and hazard ratios were calculated to assess the incidence of heat-related illnesses between groups. Statistical analysis was performed on the TriNetX platform, with survival analysis conducted via Kaplan-Meier estimates.
Analysis revealed a decreased risk of heat-related illnesses in the stimulant medication group, with a risk ratio of 0.559(95% CI: 0.485, 0.644). The mean number of events was also lower in the stimulants medication group (p=0.028). Additionally, Kaplan-Meier survival analysis indicated a higher probability of remaining free from heat-related illnesses in the stimulant group over a one-year period, with a statistically significant difference (log-rank test, χ² = 93.035, p < 0.0001).
These results suggest that stimulant medications may be associated with a reduced risk of heat-related illnesses in ADHD patients, potentially contributing to better overall outcomes in this population. Further research is warranted to explore the underlying mechanisms and to confirm these findings across larger and more varied patient populations.
注意缺陷多动障碍（ADHD）是一种常见的神经发育障碍，影响着相当一部分人群，通常使用兴奋剂药物进行治疗。这些药物虽然有效，但与体温调节功能障碍以及与热相关不良事件的风险增加有关。本研究旨在比较接受兴奋剂药物治疗的ADHD患者与未接受这些治疗的患者中此类事件的发生率。
利用来自全球研究网络的去识别电子病历进行了一项回顾性队列研究。研究人群包括年龄在6至24岁的接受兴奋剂药物治疗的ADHD患者，以及未接受兴奋剂药物治疗的ADHD患者作为对照组。从首次纳入队列的日期（索引事件）开始对患者进行为期一年的随访，以追踪与热相关的疾病，包括脱水、体温过高、中暑和其他与热相关的病症。采用倾向得分匹配来平衡队列之间的基线特征（年龄、性别）。计算风险比、优势比和风险比以评估各组中与热相关疾病的发生率。在TriNetX平台上进行统计分析，通过Kaplan-Meier估计进行生存分析。
分析显示，兴奋剂药物治疗组中与热相关疾病的风险降低，风险比为0.559（95%置信区间：0.485，0.644）。兴奋剂药物治疗组的事件平均数也较低（p = 0.028）。此外，Kaplan-Meier生存分析表明，在一年期间，兴奋剂治疗组中无热相关疾病的概率更高，差异具有统计学意义（对数秩检验，χ² = 93.035，p < 0.0001）。
这些结果表明，兴奋剂药物可能与ADHD患者中与热相关疾病的风险降低有关，这可能有助于改善该人群的总体预后。有必要进行进一步的研究以探索潜在机制，并在更大且更多样化的患者群体中证实这些发现。
