ADHD drugs may up risk of heart problems in kids, study finds

July 4, 2014 by Randy Dotinga, Healthday Reporter
ADHD drugs may up risk of heart problems in kids, study finds
But problems are rare, findings should not cause alarm, experts say.

(HealthDay)—Whether drugs used to treat attention deficit hyperactivity disorder boost the risk of heart conditions in children remains a subject of concern. Now, research from Denmark suggests medications such as Ritalin and Concerta make rare cardiac problems twice as likely, although still uncommon.

"The risk of adverse cardiac effects of ADHD medication is real and should not be forgotten," said study lead author Dr. Soren Dalsgaard, an associate professor at Aarhus University.

However, doctors and parents should not be alarmed and take kids off stimulant medication if they have benefits from it and no cardiac symptoms, he said. "But we should continue to monitor cardiovascular status," he added.

The findings aren't definitive because they don't prove cause-and-effect and they seem to conflict with some previous research that looked at fewer heart conditions over shorter periods of time.

The inattention, hyperactivity and impulsivity associated with ADHD can make it hard for children with the disorder to learn and socialize. Stimulant drugs taken on a daily basis can help control these behaviors.

Worldwide, the number of children and teens with ADHD who take stimulant medications is increasing, according to background research in the study. Experts say these drugs can boost heart rate and blood pressure.

"The most common cardiac effects are benign—very small, clinically insignificant increases in heart rate or blood pressure," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York in New Hyde Park.

Alarms sounded because of reports of sudden deaths, heart attack and stroke related to ADHD drugs, which has led some physicians to assess heart health before starting young people on the drugs.

But a 2011 study of U.S. children and young adults published in the New England Journal of Medicine found no link between ADHD drugs and heart attacks, sudden death and stroke. And in 2012, a study in the Journal of the American Medical Association found no sign of a link in young and middle-aged adults either.

The new study, published online recently in the Journal of Child and Adolescent Psychopharmacology, followed 714,000 children in Denmark, born from 1990 to 1999, for an average of 9.5 years. Of those, 8,300 were diagnosed with ADHD after age 5.

Of the total with ADHD, 111 kids—or a little more than 1 percent—had a heart problem such as high , cardiac arrest, irregular heartbeat or general cardiovascular disease.

When the researchers adjusted their statistics to take into account certain differences, they found those who took methylphenidates such as Ritalin or Concerta—whether diagnosed with ADHD or not—were about twice as likely to suffer from .

The researchers didn't examine whether ADHD itself could be linked to heart problems.

In a news release, journal editor Dr. Harold Koplewicz said the study "confirms the small but real risk we have understood for some time through prior reports and clinical experience." Koplewicz is president of the Child Mind Institute in New York City.

The findings raise the question of whether the benefits of the drugs outweigh the possible harms. In the big picture, few children who took the drugs actually developed heart problems, study lead author Dalsgaard said.

"Indeed, the benefits from ADHD medication can be worth the risk of adverse effects, but we should not underestimate the risk of cardiac effects," he said.

Adesman emphasized the rarity of heart problems in ADHD patients. Parents may wish to talk to a pediatric cardiologist if their child has an existing heart problem and they wish to put them on a stimulant for ADHD, he said.

"In my experience, most cardiologists will support treatment with for most with congenital heart disease—even for kids who have had to repair a malformed heart," he said.

More research is planned, Dalsgaard said, especially to unravel an unusual finding in the study. Children seemed at higher risk of heart problems if their doctors had lowered their dosage. It's not clear if the change in dose contributed to the issues or whether there's another explanation.

Explore further: Does psychostimulant use increase cardiovascular risk in children with ADHD?

More information: For more about ADHD, see the U.S. National Institute of Mental Health.

Related Stories

Does psychostimulant use increase cardiovascular risk in children with ADHD?

June 26, 2014
Psychostimulant use to treat children and adolescents with attention-deficit/hyperactivity disorder (ADHD) is increasing worldwide, and the evaluation of the cardiovascular safety of stimulant medication used in treatment ...

Children with ADHD prone to substance use disorders

July 1, 2014
(HealthDay)—Screening for substance use disorders (SUDs) and the safe use of stimulant medications are important issues in the care of children with attention-deficit/hyperactivity disorder (ADHD), according to research ...

Nearly 50 percent of M.D.s believe diversion of ADHD stimulant medications among teens is a problem

May 3, 2014
Two recent studies by investigators at the Cohen Children's Medical Center of New York examined physicians' perceptions and knowledge of diversion of stimulant medications for Attention Deficit Hyperactivity Disorder (ADHD) ...

No heart attack risk from attention-deficit drugs: study

November 1, 2011
A major study of more than one million children and young adults has shown no higher risk of heart attack among those who take drugs for attention deficit hyperactivity disorder, a US study said Tuesday.

Five-fold increase in ADHD medication use in children and adolescents

September 10, 2013
Use of stimulant medications to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents has increased significantly over the past several years. This trend toward increased use of prescription stimulants ...

ADHD treatment associated with lower smoking rates

May 12, 2014
Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when medication is taken consistently, according to an analysis led by researchers at Duke Medicine.

Recommended for you

Nearly a third of college kids think ADHD meds boost grades

October 16, 2017
(HealthDay)—Many college students who abuse ADHD drugs mistakenly believe that doing so will lead to better grades, a new survey suggests.

School year 'relative age' causing bias in ADHD diagnosis, says research

October 9, 2017
Younger primary school children are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older peers within the same school year, new research has shown.

Eye movements reveal temporal expectation deficits in ADHD

September 12, 2017
A technique that measures tiny movements of the eyes may help scientists better understand and perhaps eventually improve assessment of ADHD, according to new research published in Psychological Science.

ADHD medication tied to lower risk for alcohol, drug abuse in teens and adults

July 13, 2017
The use of medication to treat attention deficient hyperactivity disorder is linked to significantly lower risk for substance use problems in adolescents and adults with ADHD, according to a study led by researchers at Indiana ...

Video game promotes better attention skills in some children with sensory processing dysfunction

April 6, 2017
A video game under development as a medical device boosts attention in some children with sensory processing dysfunction, or SPD, a condition that can make the sound of a vacuum, or contact with a clothing tag intolerable ...

Children with ADHD often live in chaotic households

March 9, 2017
Researchers often observe inadequate parenting, a negative emotional climate and household chaos in families of children with ADHD. A research group at Goethe University Frankfurt and the universities of Bremen, Heidelberg, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.