Prolonged Use of ADHD Medications is Associated with Testosterone Hypofunction – Results from a National Claims Database Analysis

Abstract

Abstract Male hypogonadism is not a risk associated with ADHD stimulant medications, but recent studies have explored this connection. Though the exact pathophysiologic connection remains unclear, we predicted that long-term use of ADHD stimulant medications could increase the risk of hypogonadism in post-pubertal males. Utilizing the national TriNetX, LLC Research Network, individuals older than 18 with a diagnosis of ADHD receiving long-term stimulant medication (> 36 monthly prescriptions) were selected for the study population. Two control groups were constructed: individuals with ADHD but no stimulant medication use, and individuals without ADHD or stimulant medication use. A diagnosis of testicular hypofunction (ICD-10: E29.1) within five years of long-term ADHD stimulant medication use was chosen as the primary outcome. After propensity score matching, 17 224 men were analyzed in each group. Of the men with long-term ADHD stimulant medication use, 1.20% were subsequently diagnosed with testicular hypofunction compared to 0.67% of individuals with ADHD but no associated medication use (RR: 1.78, 95% CI: 1.42–2.23) and 0.68% in men without an ADHD diagnosis or stimulant medication use (RR: 1.75, 95% CI: 1.39–2.19). Therefore, chronic ADHD stimulant medication use was found to be significantly associated with a subsequent diagnosis of testicular hypofunction.