Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder

Zarah van der Pal; Hilde M Geurts; Jonas M B Haslbeck; Alex van Keeken; Anne Marijn Bruijn; Linda Douw; Daan van Rooij; Barbara Franke; Jan Buitelaar; Nanda Rommelse; Catharina Hartman; Jaap Oosterlaan; Marjolein Luman; Liesbeth Reneman; Pieter J Hoekstra; Tessa F Blanken; Anouk Schrantee

doi:10.1007/s00787-024-02610-8

Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder

Zarah van der Pal^*, Hilde M Geurts, Jonas M B Haslbeck, Alex van Keeken, Anne Marijn Bruijn, Linda Douw, Daan van Rooij, Barbara Franke, Jan Buitelaar, Nanda Rommelse, Catharina Hartman, Jaap Oosterlaan, Marjolein Luman, Liesbeth Reneman, Pieter J Hoekstra, Tessa F Blanken, Anouk Schrantee

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Stimulant medication is effective in alleviating overall symptom severity of attention-deficit/hyperactivity disorder (ADHD), yet interindividual variability in treatment response and tolerability still exists. While network analysis has identified differences in ADHD symptom relations, the impact of stimulant medication remains unexplored. Increased understanding of this association could provide valuable insights for optimizing treatment approaches for individuals with ADHD. In this study, we compared and characterized ADHD symptom networks (including 18 ADHD symptoms) between stimulant-treated (n = 348) and untreated (n = 70) individuals with ADHD and non-ADHD controls (NACs; n = 444). Moreover, we compared symptom networks between subgroups defined by their stimulant treatment trajectory (early-and-intense use, late-and-moderate use). Stimulant-treated individuals with ADHD showed stronger associations between symptoms, compared with untreated individuals with ADHD and NACs. We found no differences in symptom networks between the stimulant treatment trajectory subgroups. Prospective longitudinal studies are needed to disentangle whether the identified differences stem from treatment or pre-existing factors.

Original language	English
Pages (from-to)	1917–1929
Number of pages	13
Journal	European child & adolescent psychiatry
Volume	34
Issue number	6
Early online date	11 Nov 2024
DOIs	https://doi.org/10.1007/s00787-024-02610-8
Publication status	Published - 2025
Externally published	Yes

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Funding

We would like to thank all participants and their parents for their contribution to this study. A preprint version of this manuscript is available at psyArXiv (DOI: 10.31234/osf.io/3mebk).

Funders	Funder number
Horizon 2020 Framework Programme	847818

Keywords

Attention-deficit/hyperactivity disorder
Psychopharmacology
Stimulant medication
Symptom networks

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10.1007/s00787-024-02610-8

Cite this

van der Pal, Z., Geurts, H. M., Haslbeck, J. M. B., van Keeken, A., Bruijn, A. M., Douw, L., van Rooij, D., Franke, B., Buitelaar, J., Rommelse, N., Hartman, C., Oosterlaan, J., Luman, M., Reneman, L., Hoekstra, P. J., Blanken, T. F., & Schrantee, A. (2025). Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder. European child & adolescent psychiatry, 34(6), 1917–1929. https://doi.org/10.1007/s00787-024-02610-8

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abstract = "Stimulant medication is effective in alleviating overall symptom severity of attention-deficit/hyperactivity disorder (ADHD), yet interindividual variability in treatment response and tolerability still exists. While network analysis has identified differences in ADHD symptom relations, the impact of stimulant medication remains unexplored. Increased understanding of this association could provide valuable insights for optimizing treatment approaches for individuals with ADHD. In this study, we compared and characterized ADHD symptom networks (including 18 ADHD symptoms) between stimulant-treated (n = 348) and untreated (n = 70) individuals with ADHD and non-ADHD controls (NACs; n = 444). Moreover, we compared symptom networks between subgroups defined by their stimulant treatment trajectory (early-and-intense use, late-and-moderate use). Stimulant-treated individuals with ADHD showed stronger associations between symptoms, compared with untreated individuals with ADHD and NACs. We found no differences in symptom networks between the stimulant treatment trajectory subgroups. Prospective longitudinal studies are needed to disentangle whether the identified differences stem from treatment or pre-existing factors.",

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doi = "10.1007/s00787-024-02610-8",

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van der Pal, Z, Geurts, HM, Haslbeck, JMB, van Keeken, A, Bruijn, AM, Douw, L, van Rooij, D, Franke, B, Buitelaar, J, Rommelse, N, Hartman, C, Oosterlaan, J, Luman, M, Reneman, L, Hoekstra, PJ, Blanken, TF & Schrantee, A 2025, 'Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder', European child & adolescent psychiatry, vol. 34, no. 6, pp. 1917–1929. https://doi.org/10.1007/s00787-024-02610-8

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AU - van der Pal, Zarah

AU - Geurts, Hilde M

AU - Haslbeck, Jonas M B

AU - van Keeken, Alex

AU - Bruijn, Anne Marijn

AU - Douw, Linda

AU - van Rooij, Daan

AU - Franke, Barbara

AU - Buitelaar, Jan

AU - Rommelse, Nanda

AU - Hartman, Catharina

AU - Oosterlaan, Jaap

AU - Luman, Marjolein

AU - Reneman, Liesbeth

AU - Hoekstra, Pieter J

AU - Blanken, Tessa F

AU - Schrantee, Anouk

PY - 2025

Y1 - 2025

N2 - Stimulant medication is effective in alleviating overall symptom severity of attention-deficit/hyperactivity disorder (ADHD), yet interindividual variability in treatment response and tolerability still exists. While network analysis has identified differences in ADHD symptom relations, the impact of stimulant medication remains unexplored. Increased understanding of this association could provide valuable insights for optimizing treatment approaches for individuals with ADHD. In this study, we compared and characterized ADHD symptom networks (including 18 ADHD symptoms) between stimulant-treated (n = 348) and untreated (n = 70) individuals with ADHD and non-ADHD controls (NACs; n = 444). Moreover, we compared symptom networks between subgroups defined by their stimulant treatment trajectory (early-and-intense use, late-and-moderate use). Stimulant-treated individuals with ADHD showed stronger associations between symptoms, compared with untreated individuals with ADHD and NACs. We found no differences in symptom networks between the stimulant treatment trajectory subgroups. Prospective longitudinal studies are needed to disentangle whether the identified differences stem from treatment or pre-existing factors.

AB - Stimulant medication is effective in alleviating overall symptom severity of attention-deficit/hyperactivity disorder (ADHD), yet interindividual variability in treatment response and tolerability still exists. While network analysis has identified differences in ADHD symptom relations, the impact of stimulant medication remains unexplored. Increased understanding of this association could provide valuable insights for optimizing treatment approaches for individuals with ADHD. In this study, we compared and characterized ADHD symptom networks (including 18 ADHD symptoms) between stimulant-treated (n = 348) and untreated (n = 70) individuals with ADHD and non-ADHD controls (NACs; n = 444). Moreover, we compared symptom networks between subgroups defined by their stimulant treatment trajectory (early-and-intense use, late-and-moderate use). Stimulant-treated individuals with ADHD showed stronger associations between symptoms, compared with untreated individuals with ADHD and NACs. We found no differences in symptom networks between the stimulant treatment trajectory subgroups. Prospective longitudinal studies are needed to disentangle whether the identified differences stem from treatment or pre-existing factors.

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KW - Psychopharmacology

KW - Stimulant medication

KW - Symptom networks

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DO - 10.1007/s00787-024-02610-8

M3 - Article

C2 - 39527154

SN - 1018-8827

VL - 34

SP - 1917

EP - 1929

JO - European child & adolescent psychiatry

JF - European child & adolescent psychiatry

IS - 6

ER -

Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder

Abstract

Bibliographical note

Funding

Keywords

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