Shots - Health Blog
Mon December 12, 2011
ADHD Drugs Show Little Risk For Most Adults' Hearts
Originally published on Tue December 13, 2011 11:36 am
Kids aren't the only ones taking drugs for ADHD.
In fact, over the past decade or so, use of the drugs by adults has grown at a far faster rate than it has for children, according to data from drug benefits manager Medco.
Do these stimulants, such as Ritalin, raise the risk of heart attacks and strokes? It's plausible. The ADHD drugs can raise blood pressure and heart rate. There have been reports of heart trouble in some people taking the medicines. And adults, by and large, have a greater risk for cardiovascular disease than kids.
The Food and Drug Administration has been looking at the issue for years and has helped fund some studies, including one published online today by JAMA, the Journal of the American Medical Association.
The analysis of medical records for more than 400,000 users and nonusers of ADHD drugs found no association between use of the medicines and serious cardiovascular problems, including heart attacks and strokes, in adults.
"Now there is solid evidence — perhaps even some heartening news — that physicians can use to address concerns about cardiovascular risk," an accompanying editorial says. (Another recently published study found scant risks for kids.)
Still, doctors and patients need to talk about the risks and patients' medical particulars, such as family history and risks for cardiovascular disease, before deciding on a course of ADHD medicines.
"In this particular study they didn't pick up a signal" for trouble, says John Harold, vice president of the American College of Cardiology and an attending physician at the Cedars-Sinai Heart Institute in Los Angeles. The findings aren't a big surprise, he tells Shots, but that doesn't meant doctors have "carte blanche" to prescribe the medicines to anyone.
"It's incumbent on clinicians to treat every patient as an individual and perform an individual risk assessment," he says. That might include an electrocardiogram first.
"If you take a good history, listen to a patient's complaints and explore their medical and family history," then you have a good chance of finding any underlying risks, he says. That information can then inform a decision about proceeding with a prescription for an ADHD drug, or not.