What predicts whether you stay on ADHD medication — not side effects, what you believe ADHD is

Bottom line

A survey of 1,050 Danish adults who’d just started ADHD medication found the single clearest predictor of whether they were still on it a year later wasn’t a side effect, a symptom score, or a demographic factor. It was whether they believed ADHD is a biological condition or something society constructed. People who saw it as biological stayed on the medication; people who saw it as a social construct stopped, and reported more negative feelings about the drug while they were on it.

The research

Johannessen et al. 2026 drew a representative sample of 4,748 Danish adults from the 16,284 who redeemed a first-ever ADHD medication prescription between 2017 and 2019; 1,050 completed the questionnaire, split evenly between people who’d continued (defined as no 12-month gap between prescription refills) and people who’d discontinued. It’s a mixed-methods design — the survey’s themes came out of six patient interviews first, then were tested across the full sample with two-way (continuation vs. discontinuation × male vs. female) analyses.

The result: people who continued treatment were significantly more likely to describe ADHD as a biological illness; people who discontinued were more likely to describe it as an illness constructed by society, and reported more negative feelings about the medication’s effect on their lives. There was also a gender split inside that pattern — men were more likely than women to hold the “socially constructed” view, while women who continued reported higher benefit specifically for work, school, social functioning, and being able to enjoy time alone.

This is a self-selected survey sample (people who didn’t respond may differ systematically from those who did) and the design can’t settle which way causality runs. Believing ADHD is biological could lead someone to stay on medication — or staying on medication and feeling it work could be what makes someone describe ADHD as biological in the first place. The paper doesn’t resolve that, and neither does this briefing.

What this means

If you’ve stopped ADHD medication, or are thinking about it, this is worth sitting with honestly: is the decision about the drug’s actual effects on you, or about whether you’ve made peace with ADHD being a real, biological thing rather than a label. Those are different questions, and only one of them is about the medication. If you’re a partner, family member, or clinician of someone who stopped, this suggests the more useful conversation isn’t always “what side effect made you stop” — it might be “do you believe this is really what’s going on with you.”

Read next on this site:

• ADHD medication — the general medication-decision framework this finding adds a missing piece to: why people stop, not just what to expect.
• The medication cliff — the mechanism-based reasons medication can feel like it’s stopped working, distinct from a belief-driven decision to quit.
• Shame and adult ADHD — the internalised-stigma territory that “ADHD as a social construct” sits close to.