Dr Anders Holt Department of Cardiology Copenhagen University Hospital–Herlev and Gentofte Gentofte Hospitalsvej Hellerup, Denmark

Study Raises Concerns About Long Term Adult Use of ADHD Meds and Elevated Risk of Stroke and Heart Disease

MedicalResearch.com Interview with:

Dr Anders HoltDepartment of Cardiology Copenhagen University Hospital–Herlev and Gentofte Gentofte Hospitalsvej Hellerup, Denmark

Dr. Holt

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.

MedicalResearch.com: What are the main findings?

Response:  In this nationwide cohort study of 73 264 adult first-time users of ADHD treatment, associations between treatment and elevated 10-year risk of stroke, heart failure, and a composite cardiovascular outcome were found.

Furthermore, a dose-response seemed likely with a stepwise increase in 10-year risk comparing individuals on higher dosage with lower dosage and prior use. No associations with increased risk of acute coronary syndromes were found . 

MedicalResearch.com: What should readers take away from your report?

Response: With a growing target population, potentially treatable drug-safety concerns regarding ADHD treatment should be explored.

Potential associations between long-term use of ADHD treatment and an elevated risk of stroke and heart failure in a young patient group is vital knowledge for all physicians overseeing patients with ADHD. Furthermore, improved attention to existent cardiovascular risk factors at initiation as well as cardiovascular symptoms during treatment could be warranted in these patients—with enhanced focus on older patients and higher dosage for extended periods.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Hopefully, findings from this and other observational studies can inspire future clinical research focusing on long-term cardiovascular risk following ADHD treatment. Particularly focusing on potential high risk groups to better mitigate potential risk.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: I would always like to add that these data were observational and should always interpreted with that in mind.

I have no disclosures in relation to this study.

Citation: Holt, A, Strange, J, Rasmussen, P. et al. Long-Term Cardiovascular Risk Associated With Treatment of Attention-Deficit/Hyperactivity Disorder in Adults. J Am Coll Cardiol. 2024 May, 83 (19) 1870–1882.

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Last Updated on May 7, 2024 by Marie Benz MD FAAD