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

## TL;DR

This study explores how stimulant medication affects the relationships between ADHD symptoms in treated and untreated individuals.

## Contribution

The study is the first to use network analysis to compare ADHD symptom interrelations in stimulant-treated and untreated individuals.

## Key findings

- Stimulant-treated individuals showed stronger symptom associations compared to untreated individuals and controls.
- No differences were found between subgroups based on stimulant treatment trajectory.
- Longitudinal studies are needed to determine if differences are due to treatment or pre-existing factors.

## 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.

The online version contains supplementary material available at 10.1007/s00787-024-02610-8.