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Prescription psychostimulants or atomoxetine and the risk of stimulant-related hospital admissions in adults with and without stimulant use disorder: a Swedish population-based within-individual observational study

Background - Concerns exist that psychostimulant treatment increases the risk of misuse, particularly in individuals with a history of stimulant use disorder (SUD). This study assessed changes in the risk of stimulant-related hospitalizations after initiating treatment with psychostimulants or atomo...

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Main Authors: Bach, Patrick (Author) , Franck, Johan (Author) , Hällgren, Jonas (Author) , Widing, Härje (Author) , Gissler, Mika (Author) , Westman, Jeanette (Author)
Format: Article (Journal)
Language:English
Published: June 2026
In: The lancet. Regional health
Year: 2026, Volume: 65, Pages: 111
ISSN:2666-7762
DOI:10.1016/j.lanepe.2026.101658
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.lanepe.2026.101658
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2666776226000700
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Author Notes:Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, and Jeanette Westman
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Summary:Background - Concerns exist that psychostimulant treatment increases the risk of misuse, particularly in individuals with a history of stimulant use disorder (SUD). This study assessed changes in the risk of stimulant-related hospitalizations after initiating treatment with psychostimulants or atomoxetine in individuals with and without SUD. - Methods - This population-based study used Swedish registers to identify adults with and without history of SUD, who used psychostimulants or atomoxetine, a non-stimulant prescription medication, between 2008 and 2021. A within-individual design was used to compare the rate ratios (RR) of stimulant-related hospitalizations in two six months periods before and after treatment initiation. Stimulant-related hospitalizations were defined as any hospital visit with a stimulant-related main diagnosis. - Findings - Of the 132,666 adults receiving psychostimulants or atomoxetine, 2·4% (3161/132,666) had a history of SUD, while 97·6% (129,505/132,666) did not. The RR for stimulant-related hospitalizations in the six months following treatment initiation was 0·79 (95% CI 0·62-0·99) for individuals with a history of SUD and 0·84 (0·70-1·02) for those without, compared to the 6-month period before treatment initiation. Results were similar across sexes, age groups, and medication classes and sensitivity analyses comparing 8-/12-/52-week periods before and after treatment initiation were consistent with the main findings. - Interpretation - We did not observe higher rates of stimulant-related hospitalizations in the 6-month period after initiation of treatment with psychostimulants or atomoxetine in individuals with or without a history of SUD. The observed associations are consistent with a reassuring safety profile and may help inform clinical decision-making when considered alongside clinical guidelines. - Funding - This research was funded by FORTE (2020-00467), Karolinska Institutet (KID, 2020-02653), and Region Stockholm (FoUI-977024).
Item Description:Online verfügbar: 24. März 2026, Artikelversion: 24. März 2026
Gesehen am 20.04.2026
Physical Description:Online Resource
ISSN:2666-7762
DOI:10.1016/j.lanepe.2026.101658

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