Psychiatric and neurological predictors of early ADHD medication discontinuation across the lifespan: a multinational study - Report - MDSpire

Psychiatric and neurological predictors of early ADHD medication discontinuation across the lifespan: a multinational study

  • By

  • Isabell Brikell

  • Aske Astrup

  • Theresa Wimberley

  • Masako Araki

  • Zheng Chang

  • Ditte Demontis

  • Zihan Dong

  • Stephen V Faraone

  • Le Gao

  • Malcolm B Gillies

  • Jan Haavik

  • Catharina Hartman

  • Henrik Larsson

  • Kenneth K C Man

  • Sallie-Anne Pearson

  • Harold Snieder

  • Melissa Vos

  • Ian C K Wong

  • Honghui Yao

  • Andrew SC Yuen

  • Yanli Zhang-James

  • Yiling Zhou

  • Helga Zoega

  • Anders Engeland

  • Søren Dalsgaard

  • Kari Klungsøyr

  • July 2, 2026

  • 0 min

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Predictors of Early Discontinuation of ADHD Medication: A Multinational Study

Overview

This study investigates predictors of early discontinuation of ADHD medication across various age groups and countries, identifying significant psychiatric and neurological comorbidities that influence discontinuation rates in children.

Background

ADHD affects a significant portion of the population, and medication adherence is crucial for effective management. High rates of discontinuation, especially among adolescents and young adults, can lead to adverse outcomes. Understanding predictors of discontinuation is essential for tailoring treatment strategies.

Data Highlights

Age GroupDiscontinuation RatePredictors
Children19%–61%Intellectual disability, autism, psychotropic medication use
Adolescents37%–68%No significant predictors
Young Adults52%–67%Conduct/oppositional defiant disorder
Adults38%–68%Schizophrenia, tic disorders

Key Findings

  • Discontinuation rates varied significantly by age group and country.
  • In children, predictors included intellectual disability and autism.
  • Conduct/oppositional defiant disorder was associated with earlier discontinuation in young adults.
  • In adults, schizophrenia and tic disorders were associated with earlier discontinuation.
  • Statistical heterogeneity was observed, particularly in US estimates.

Clinical Implications

Clinicians should monitor children with neuropsychiatric comorbidities to improve medication persistence. For adolescents and adults, broader factors may need to be considered in treatment planning.

Conclusion

Understanding comorbidities is important in predicting ADHD medication discontinuation, particularly in children, while further research is needed in older age groups.

Related Resources & Content

  1. BMJ Mental Health, 2024 -- ADHD medication discontinuation and non-adherence: a Norwegian population-based register study
  2. conexiant, 2024 -- ADHD Diagnosis Timing Linked to School Outcomes
  3. Frontiers in Psychiatry, 2026 -- Adult-diagnosed and childhood-diagnosed attention deficit/hyperactivity disorder: cognitive and environmental contributions to symptom severity across different age of diagnosis
  4. NICE, 2025 -- Attention deficit hyperactivity disorder: diagnosis and management
  5. American Academy of Pediatrics, 2019 -- Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
  6. Frontiers in Psychiatry — Psychotherapy initiation is associated with discontinuation of psychotropic medications without dose escalation: a ten-year real-world cohort study (2014-2024)
  7. NICE Guidance on ADHD
  8. AAP ADHD Guidelines
  9. Pharmacological interventions for ADHD: a systematic review and dose–effect network meta-analysis - ScienceDirect
  10. Discontinuation and reinitiation of pharmacological treatment for ADHD among individuals with ADHD and substance use disorder
  11. Drug survival and risk factors for ADHD medication discontinuation in adults: A Danish Nationwide Registry‐based cohort study - Ishøy - 2024 - Acta Psychiatrica Scandinavica - Wiley Online Library
  12. Transitioning From Pediatric to Adult Psychiatric Care for ADHD in Sweden: A Nationwide Study
  13. Recommendations | Attention deficit hyperactivity disorder: diagnosis and management | Guidance | NICE

Original Source(s)

Psychiatric and neurological predictors of early ADHD medication discontinuation across the lifespan: a multinational study

  • by Isabell Brikell, Aske Astrup, Theresa Wimberley, Masako Araki, Zheng Chang, Ditte Demontis, Zihan Dong, Stephen V Faraone, Le Gao, Malcolm B Gillies, Jan Haavik, Catharina Hartman, Henrik Larsson, Kenneth K C Man, Sallie-Anne Pearson, Harold Snieder, Melissa Vos, Ian C K Wong, Honghui Yao, Andrew SC Yuen, Yanli Zhang-James, Yiling Zhou, Helga Zoega, Anders Engeland, Søren Dalsgaard, Kari Klungsøyr

  • July 2, 2026

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