TY  - JOUR
PY  - 2014//
TI  - Methylphenidate and the risk of trauma
JO  - Pediatrics
A1  - Man, Kenneth K. C.
A1  - Chan, Esther W.
A1  - Coghill, David
A1  - Douglas, Ian
A1  - Ip, Patrick
A1  - Leung, Ling-Pong
A1  - Tsui, Matthew S. H.
A1  - Wong, Wilfred H. S.
A1  - Wong, Ian C. K.
SP  - 40
EP  - 48
VL  - 135
IS  - 1
N2  - BACKGROUND AND OBJECTIVE: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are prone to sustaining trauma that requires emergency department (ED) admission. Methylphenidate (MPH) can reduce ADHD symptoms and may thus theoretically reduce the risk of trauma-related ED admission, but previous studies do not make this association clear. This study examines this association. <br><br>METHODS: A total of 17 381 patients aged 6 to 19 years who received MPH prescriptions were identified by using the Clinical Data Analysis & Reporting System (2001-2013). Using a self-controlled case series study design, the relative incidence of trauma-related ED admissions was compared with periods of patient exposure and nonexposure to MPH. <br><br>RESULTS: Among 17 381 patients prescribed MPH, 4934 had at least 1 trauma-related ED admission. The rate of trauma-related ED admission was lower during exposed periods compared with nonexposed periods (incidence rate ratio [IRR]: 0.91 [95% confidence interval (CI): 0.86-0.97]). The findings were similar only when the incident trauma episode was assessed (IRR: 0.89 [95% CI: 0.82-0.96]). A similar protective association was found in both genders. In validation analysis using nontrauma-related ED admissions as a negative control outcome, no statistically significant association was found (IRR: 0.99 [95% CI: 0.95-1.02]). All sensitivity analyses demonstrated consistent results. <br><br>CONCLUSIONS: This study supports the hypothesis that MPH is associated with a reduced risk of trauma-related ED admission in children and adolescents. A similar protective association was found in both male and female patients. This protective association should be considered in clinical practice.<p />  <p>Language: en</p>
LA  - en
SN  - 0031-4005
UR  - http://dx.doi.org/10.1542/peds.2014-1738
ID  - ref1
ER  -