ADHD, Author Interviews, Heart Disease, Stroke / 07.05.2024
Study Raises Concerns About Long Term Adult Use of ADHD Meds and Elevated Risk of Stroke and Heart Disease
MedicalResearch.com Interview with:
[caption id="attachment_61634" align="alignleft" width="150"] Dr. Holt[/caption]
Dr Anders Holt MD PhD
Department of Cardiology
Copenhagen University Hospital–Herlev and Gentofte
Gentofte Hospitalsvej
Hellerup, Denmark
MedicalResearch.com: What is the background for this study? What types of ADHD treatments were in the study?
Response: An increasing number of adults are being diagnosed with ADHD and subsequently treated. Taking the drugs' effect on the sympathetic nervous system into account, it seems relevant to investigate whether treatment could be associated with an elevated long-term risk of cardiovascular disease.
The drugs included in the study were methylphenidate, atomoxetine, lisdexamfetamine, dexamfetamine, and modafinil. Owing to the fact that atomoxetine is not a sympathomimetic amine as the others, separate supplementary analyses were carried out for this drug, yielding similar results.
Dr. Holt[/caption]
Dr Anders Holt MD PhD
Department of Cardiology
Copenhagen University Hospital–Herlev and Gentofte
Gentofte Hospitalsvej
Hellerup, Denmark
MedicalResearch.com: What is the background for this study? What types of ADHD treatments were in the study?
Response: An increasing number of adults are being diagnosed with ADHD and subsequently treated. Taking the drugs' effect on the sympathetic nervous system into account, it seems relevant to investigate whether treatment could be associated with an elevated long-term risk of cardiovascular disease.
The drugs included in the study were methylphenidate, atomoxetine, lisdexamfetamine, dexamfetamine, and modafinil. Owing to the fact that atomoxetine is not a sympathomimetic amine as the others, separate supplementary analyses were carried out for this drug, yielding similar results.
Dr. Guasch-Ferré[/caption]
Marta Guasch-Ferré, PhD
Associate Professor and Deputy Head of Section, Section of Epidemiology
University of Copenhagen
Group Leader, Novo Nordisk Foundation Center for Basic Metabolic Research
Adjunct Associate Professor, Department of Nutrition
Harvard TH Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Olive oil is rich in monounsaturated fats and contains compounds with antioxidant activity that may play a protective role for the brain. Olive oil as part of a Mediterranean diet appears to have a beneficial effect against cognitive decline. Higher olive oil intake was previously associated with a lower risk of cardiovascular disease and mortality. But its association with dementia mortality was unknown.
Dr. Li Gan[/caption]
Dr. Li Gan PhD
Burton P. and Judith B. Resnick Distinguished Professor in Neurodegenerative Diseases
Brain and Mind Research Institute
Weill Cornell Medical College
[caption id="attachment_61627" align="alignleft" width="150"]
In recent years, the field of psychiatric care has undergone a revolutionary transformation. This is because of groundbreaking research that has redefined our understanding of mental health and treatment methodologies.
From innovative therapies to advanced diagnostic tools, transformative research has played a pivotal role in reshaping the landscape of psychiatric care.
In this article, we will explore the key contributions that researchers have made in this field. We will also talk about how their work is influencing the way mental health is approached and treated.
Dr. Akefe[/caption]
Isaac O Akefe DVM, PhD
Clem Jones Centre for Ageing Dementia Research
Queensland Brain Institute
The University of Queensland St Lucia
Academy for Medical Education, Medical School
Brisbane QLD Australia
MedicalResearch.com: What is the background for this study?
Response: The brain is the body’s fattiest organ, with fatty compounds called lipids making up 60% of its weight. Fatty acids are the building blocks of a class of lipids called phospholipids.
In our study, we first showed that levels of saturated fatty acids increase in the brain during neuronal communication and long-term memory formation, but we didn’t know what was causing these changes.
Lauren C. Davis, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA 19409
MedicalResearch.com: What is the background for this study?
Response: Financial conflicts of interest (COIs) resulting from ties between academia and industry have been under scrutiny for their potential to hinder the integrity of medical research. COIs can lead to implicit bias, compromise the research process, and erode public trust (1-6). The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), standardizes symptom criteria and codifies psychiatric disorders. This manual contributes to the approval of new drugs, extensions of patent exclusivity, and can influence payers and mental health professionals seeking third-party reimbursements. Given the implications of the DSM on public health, it is paramount that it is free of industry influence. Previous research has shown a high prevalence of industry ties among panel and task force members of the DSM-IV-TR and DSM-5, despite the implementation of a disclosure policy for the DSM-5 (7,8). This study (9) determined the extent and type of COIs received by panel and task-force members of the DSM-5-TR (2022) (10). As the DSM-5-TR did not disclose COI, we used the Center for Medicare and Medicaid Services Open Payments (OP) database (11) to quantify them.
Dr. Dolatshahi[/caption]
Mahsa Dolatshahi, M.D., M.P.H.
Post-doctoral research fellow
Mallinckrodt Institute of Radiology (MIR)
Washington University School of Medicine
St. Louis
MedicalResearch.com: What is the background for this study?
Response: Obesity at midlife is recognized as a risk factor for developing Alzheimer disease decades afterwards. However, body mass index on its own does not adequately represent the risks associated with obesity.
In this study, we went beyond BMI and considered anatomical distribution of body fat, including the metabolically active visceral fat in the belly, and showed its association with Alzheimer pathology in the form of amyloid proteins. In addition, visceral fat along with obesity and insulin resistance were associated with thinning of brain cortex, as early as midlife.
If you've been in a scrape and your noggin took a knock, playing it tough and shaking it off isn't the way to go. 
Dr. Belloy[/caption]
Michael E. Belloy, PhD
Department of Neurology and Neurological Sciences
Stanford University, Stanford, California
MedicalResearch.com: What is the background for this study?
Response: Apolipoprotein E (APOE)*2 and APOE*4 are, respectively, the strongest protective and risk-increasing, genetic variants for late-onset Alzheimer disease. As such, one’s APOE genotype is highly relevant towards clinical trial design and Alzheimer’s disease research. However, most insights so far are focused on the associations of these APOE genotypes with Alzheimer’s disease risk in non-Hispanic white individuals.
One important aspect of our work is that we really increased sample sizes for non-Hispanic Black, Hispanic, and East Asian individuals, so that we now have better understanding of the associations of APOE genotypes with Alzheimer’s disease risk in these groups. In complement, we also did the largest investigation to date on the role of ancestry on the associations of APOE genotypes with Alzheimer’s disease risk. The scale of our study was thus a critical factor in generating novel insights.
Dr. Harmer[/caption]
Peter A. Harmer, PhD, MPH, AT-Ret, FACSM
Senior Associate Research Scientist
Oregon Research Institute
MedicalResearch.com: What is the background for this study?
Response: Decline in various aspects of cognitive function, such as memory, executive function, and multitasking ability is common as we age. The rate and extent of decline varies among older adults but approximately 20% of those aged 65+ will experience clinically relevant mild cognitive impairment, which places them at increased risk of progressing to Alzheimer’s disease or related dementias. It is also associated with decreased mobility, increased risk of falls and impaired capacity for complex activities of daily living.
Prof. Guohua Li[/caption]
MedicalResearch.com Interview with:
Guohua Li, MD, DrPH
Finster Professor of Epidemiology and Anesthesiology
Columbia University Irving Medical Center
MedicalResearch.com: What is the background for this study? How was the ADHD diagnosis determined?
Response: The reported prevalence of ADHD in children and young adults in the United States has more than doubled since the 1990s because of improved diagnosis. Currently, ADHD affects about 13 percent of children under 18 years of age and eight percent of adults under 45 years of age. Little is known about the prevalence of ADHD in older adults although it is estimated that ADHD symptoms may persist throughout the lifespan in about one-third of children diagnosed with the disorder. Diagnostic criteria for adulthood ADHD include having five or more relevant symptoms, adverse impact on social, academic, and occupational activities, and onset of symptoms before age 12.
In this study, ADHD status is determined based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a doctor or other health professional that he or she had ADHD.
One of the most startling aspects of the connection between schizophrenia and substance abuse is the high prevalence of substance use disorders among those with schizophrenia. Studies consistently show that individuals diagnosed with schizophrenia are more likely to engage in substance abuse compared to the general population. This connection can be best demonstrated using the self-medication hypothesis. According to this hypothesis, individuals with schizophrenia may turn to substances as a way to self-medicate or alleviate their distressing symptoms. Imagine dealing with hallucinations or disorganized thoughts—some may use alcohol or drugs to temporarily escape from this internal turmoil.