Researchers advise prescribers to keep monitoring patients on ADHD drugs for symptoms of heart disease.
A new study has found that the longer individuals take drugs for so-called attention-deficit hyperactivity disorder (ADHD), the higher their risk of heart disease, particularly high blood pressure and artery diseases. This greater risk was similar for children, adolescents and adults. The study advises doctors to consider the risks when making treatment decisions.
Researchers involved in the study noted that clinical trials have found increases in heart rate and blood pressure associated with both stimulant and nonstimulant ADHD drugs. The new study investigated whether those heart-related effects led to clinically significant cardiovascular disease over time.
Using the health records of all individuals living in Sweden aged 6 to 64 who had a diagnosis of ADHD or were prescribed an ADHD drug between 2007 and 2020, the researchers found that the length of time the users took the drugs was associated with a statistically significant increase in the risk of heart disease, particularly high blood pressure and artery diseases, as compared to those not taking the drugs.
“Longer cumulative duration of ADHD medication use was associated with an increased risk of CVD [cardiovascular disease] compared with nonuse,” wrote lead author Le Zhang, Ph.D., at the Karolinska Institutet in Stockholm, Sweden. The study was e-published ahead of print in JAMA Psychiatry.
The researchers found that the risk of heart disease increased rapidly over the first three years of taking ADHD drugs, for a cumulative 3-year increased risk of 8%, after which the risk increased 4% each year. These increases in risk were similar for all ages and regardless of the gender of the individual taking the drugs. The risks were also greater with stimulant-type ADHD drugs. The researchers advised prescribers to keep monitoring patients who are taking ADHD drugs for symptoms of heart disease.
Longer cumulative duration of ADHD medication use was associated with an increased risk of [cardiovascular disease] compared with nonuse.”
— Le Zhang, Ph.D., Karolinska Institutet, Stockholm, Sweden
“Monitoring becomes even more crucial considering the increasing number of individuals engaging in long-term use of ADHD medication,” Zhang wrote.
Currently, over 9 million Americans are taking ADHD drugs, with one in three of them children under the age of 18. Concerns have been raised about the overdiagnosis of ADHD and the prescribing of ADHD drugs, especially to children, after some studies have suggested the drugs do more harm than good.
A diagnosis of ADHD for teens is associated with lower self-esteem, worse social behavior, and a significantly increased risk of self-harm, especially in those diagnosed with ADHD early in life (6-7 years of age).
Statistics from the National Poison Data System from January 2018 to September 2020 show that the number of cases of self-harm, including suicide attempts, using prescription stimulants averaged 213 a month for teenagers aged 13-19 and 71 a month for young adults aged 20-29.
The frequency with which children and teens have the drugs given to them incorrectly is rising steeply, leading to a quadrupling of related calls to poison control centers over the past two decades, with children under 6 years of age at greatest risk of a serious medical outcome from the errors.
The stimulant-type ADHD drug methylphenidate, sold under brand names including Ritalin, Concerta, Adderall and Vyvanse, has been linked to depression in children and
Methylphenidate is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II controlled substance, in the same category as cocaine, morphine, and opium. The DEA defines controlled substances as “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
The U.S. Food and Drug Administration (FDA) recently acted out of concern over prescriptions for stimulant drugs at near-record highs in the U.S., after rising by 45% from 2012 to 2021. It required new black-box warnings in the prescribing information for the stimulant drugs prescribed for ADHD “to address continuing concerns of misuse, abuse, addiction, and overdose of the prescription drugs,” and “to clearly inform patients, caregivers and healthcare professionals of these risks.” The boxed warning is the most serious warning the FDA can require for prescription drugs.
Even more fundamentally, ADHD is a label subjectively applied to a collection of behaviors common to children. A “diagnosis” of ADHD has no scientific basis – no lab tests, brain scans or any other scientific proof of it, making it a label that is far too easy to pin on children.
The late psychologist Keith Conners conducted the first formal trials on methylphenidate. He later realized that ADHD diagnoses were out of control and called ADHD misdiagnoses “a national disaster of dangerous proportions.”
The Citizens Commission on Human Rights (CCHR) urges the FDA to take stronger action to protect Americans, especially children and teens, from the risks of abuse, addiction, overdose, and other serious harms now linked to prescription stimulants.
WARNING: Anyone wishing to discontinue or change the dose of an ADHD drug or any other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.