When faced with counseling a family on whether their teen with attention deficit hyperactivity disorder (ADHD) is ready to drive, I always emphasize the importance of optimizing his or her ADHD medication regimen and making sure that the teen is taking the medication for the times s/he is driving. Therefore, I was intrigued to learn of a new JAMA Psychiatry study on the impact of medication treatment among driving outcomes in adults with ADHD. This study found that serious crash injuries were nearly 60 percent less likely among adult men when they were medicated as compared to when they were unmedicated. However, no significant reduction in crashes were seen among women with ADHD while medicated. Alarmingly, this large observational study reported a 50 percent increase in crash risk among adults with ADHD. Notably, teens were not included in this study.
While my own practice is limited to teen drivers with ADHD (and not adult drivers), this new research makes me feel even more pressed to ensure that my patients with ADHD and their parents understand the serious driving risks associated with ADHD. And especially for my male patients, I would continue to emphasize the importance of taking their ADHD medications as prescribed and closely monitoring the medications' impact so that they can be adjusted as needed. We typically obtain ADHD rating scales to quantify the effect of a new dose or new type of medication; perhaps we should consider whether there needs to be additional monitoring of efficacy during the learning-to-drive phase as well.
Click here for invited commentary on the study by my colleagues Flaura K. Winston, MD, PhD of CIRP@CHOP and Daniel Romer, PhD of the University of Pennsylvania.