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Attention deficit hyperactivity disorder (ADHD) medication is not associated with increased risk of self-harm, a study has found.
Publishing their findings in BMJ Mental Health on 12 September 2026, researchers analysed medical data from 461,024 people with ADHD and who had been prescribed medication between 1 January 2001 and 31 December 2020. Of these participants, 6,847 had an incident of self-harming during the study’s inclusion period.
The data were from patients in the UK, Hong Kong, New Zealand, South Korea and Taiwan.
The researchers looked at patients’ incidents of self-harm across three risk periods: 90 days before medication initiation, the first 90 days of medication use and the subsequent treatment period.
The risk of self-harm was highest in the 90 days before people started taking medication, with 11 to 29 events per 100 person-years across sites, and reduced in the 90 days following medicine initiation, with 0 to 23 events per 100 person-years, the study results showed.
In addition, the study results revealed that the risk reduced further with medication use beyond 90 days, with 8 to 19 events per 100 person-years.
The study authors noted that previous studies had shown inconsistent results — with some studies suggesting an increased risk shortly after treatment initiation, whereas others had found treatment initiation reduced the risk.
An increased risk of self-harm in the 90 days before medicine initiation could indicate that “the period leading up to treatment may be characterised by worsening features, emerging psychiatric comorbidity, psychosocial stressors or increased treatment-seeking”, the study authors added.
They also concluded that their findings “support timely diagnosis and treatment of ADHD while emphasising the need for ongoing monitoring of self-harm risk before and during treatment, rather than delaying treatment because of safety concerns”.
Lead author Adrienne Chan, lecturer in pharmacoepidemiology at Aston University, said: “People often worry that ADHD medication itself increases the risk of self-harm. What our findings suggest is that many people are already at their highest risk before treatment even begins.
“This highlights an important opportunity for earlier intervention. Recognising that vulnerable period could help us provide support earlier, when it may make the greatest difference.”
Commenting on the study, Henry Shelford, chief executive of ADHD UK, said: “It isn’t a surprise that people are often struggling the most before an ADHD diagnosis, as the struggle is likely what precipitated the request for mental health support. What we need to avoid is a system that requires crisis to get help and instead have one that proactively diagnoses and supports to prevent crisis in the first place.
“ADHD medication has proven impacts on reducing risks for people with ADHD around suicide, addiction, harm from increased risk-taking and now also on self-harm for people with ADHD.
“We should celebrate the knowledge and confidence this research can give people in making considered health choices.”
