ADHD News & Research

Study: ADHD Medication Use May Lower the Risk of Unemployment

ADHD medication use by adults may lower the risk for long-term unemployment by 10%, according to a new study of Swedish adults who treated their ADHD symptoms with a prescription.

May 18, 2022

ADHD medication use may decrease the risk for long-term unemployment among adults with attention deficit hyperactivity disorder, according to a recent study published in JAMA Open Network.1 The study found the association between pharmacological treatment and decreased risk of unemployment to be significantly stronger among women.

Previous research has shown that adults with ADHD face an increased risk for unemployment.2, 3, 4 Pharmacological treatments have proven effective in reducing core ADHD symptoms such as difficulty concentrating, poor planning, lack of organization, self-regulation deficits, forgetfulness, and impulsivity.5, 6

“However, less is known about the extent to which pharmacological treatment for ADHD is associated with reductions in unemployment rates,” the researchers wrote. “This is a critical limitation, because long-term unemployment is associated with economic difficulties, worse mental and physical health, and higher mortality rates.”

Researchers sought to determine whether taking medication for ADHD was associated with a lower unemployment rate among working-age adults. They studied data from 12,875 adults – 41.5% female and 58.5% male – diagnosed with ADHD in Sweden who were born between 1958 and 1978. Participants who used ADHD medication for at least 6 months during a two-year period were considered ADHD medication users. Participants served as their own control in the study.

During the 2008-2013 follow-up period, participants who had used ADHD medication experienced a 10% lower risk of long-term unemployment the following year. Lower long-term unemployment rates were found during treatment periods compared to non-treatment periods. Significant associations were found in women, which could support previous research reports highlighting greater improvement in ADHD symptoms for women.7  Long-term unemployment was defined as 90 days or more in a calendar year.

Researchers found a slightly stronger association among younger adults than older adults, and in individuals with more than nine years of education.

“To our knowledge, this is the largest population-based longitudinal study to assess the association of pharmacological treatment of ADHD with subsequent long-term unemployment among middle-aged adults,” the researchers wrote.

Among the 69% of participants who used ADHD medication during the study’s follow-up period, only 3% continued with persistent treatment. Previous research has shown that few adults with ADHD achieve consistent long-term pharmacological care, oftentimes starting and stopping or discontinuing treatment altogether.8

Approximately 70% of study participants had at least one other psychiatric ADHD comorbidity – mainly depressive disorder, anxiety disorder, and substance use disorder. The majority had at least nine years of education.

At least one long-term unemployment event was recorded for 39% of women and 41% of men during the study period.

The significance of this study and additional like-minded analyses could prove highly beneficial for individuals experiencing untreated ADHD symptoms and other comorbidities, most notably following a pandemic that left many adults unemployed.

“Although our observed effect size may be viewed as small in magnitude, a reduction of 10% in the risk of long-term unemployment might translate into a substantial decrement of the economic burden at the societal level,” the researchers stated. “The potential beneficial associations of medication use with long-term unemployment should be carefully weighed against potential adverse effects of medication.”

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1Li, L., Chang, Z., Sun, J., et al. (2022). Association Between Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder and Long-term Unemployment Among Working-Age Individuals in Sweden. JAMA Netw Open, 5(4), e226815. doi:10.1001/jamanetworkopen.2022.6815

2Jangmo, A., Kuja-Halkola, R., Pérez-Vigil, A., et al. (2021). Attention-deficit/hyperactivity disorder and occupational outcomes: the role of educational attainment, comorbid developmental disorders, and intellectual disability. PLoS One, 16(3), e0247724. doi:10.1371/journal.pone.0247724

3Klein, R.G., Mannuzza, S., Olazagasti, M.A.R., et al. (2012). Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry, 69(12), 1295-1303. doi:10.1001/archgenpsychiatry.2012.271

4Gjervan, B., Torgersen, T., Nordahl, H.M., & Rasmussen, K. (2012). Functional impairment and occupational outcome in adults with ADHD. J Atten Disord, 16(7), 544-552. doi:10.1177/1087054711413074

5Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., & Hechtman, L. (2008). Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat, 4(2), 389-403.

6Cortese, S., Adamo, N., Del Giovane, C., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry, 5(9), 727-738. doi:10.1016/S2215-0366(18)30269-4

7Weiss, M.D., Gibbins, C., Goodman, D.W., Hodgkins, P.S., Landgraf, J.M., & Faraone, S.V. (2010). Moderators and mediators of symptoms and quality of life outcomes in an open-label study of adults treated for attention-deficit/hyperactivity disorder. J Clin Psychiatry, 71(4), 381-390. doi:10.4088/JCP.08m04709pur

8Gajria, K., Lu, M., Sikirica, V., et al. (2014). Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder: a systematic literature review. Neuropsychiatr Dis Treat, 10, 1543-1569.