When kids or adults suffer with a neurodevelopmental condition known as Attention Deficit Hyperactivity Disorder, or ADHD, it can lead to troubled relationships, reckless behavior and difficulty in school or at work — which often results in low self-esteem and depression.
Stimulant medications are frequently prescribed to help these people deal with their disorder. But a new Swedish study points to this treatment's possible risky side effect: cardiovascular disease.
People taking stimulating ADHD drugs like Ritalin and Adderall have a significantly higher risk of hypertension and arterial disease, the researchers found. What's more, the chance of getting these serious cardiovascular issues increases the longer patients are taking the medications.
It's a growing population. About one in 10 children ages 3 to 17 have been diagnosed with ADHD , according to data from the U.S. Centers for Disease Control and Prevention. It's also becoming a more common diagnosis among adults, affecting around five percent of adult Americans.The risk for heart disease was 23 percent higher overall for people who have used ADHD medication for more than five years, compared with those who did not take medication.
The Swedish study was led by Le Zhang from the department of medical epidemiology and biostatistics at Karolinska Institute in Stockholm. Le Zhang and her colleagues analyzed the association between long-term use of ADHD medication and the risk of developing cardiovascular diseases. They examined all ADHD medications prescribed in Sweden during the study period, including stimulants such as amphetamine and dexamphetamine, as well as nonstimulants.
The investigators drew data from a Swedish nationwide database and collected diagnoses from a National Impatient Registrar. The large sample included over 278,000 participants between the ages of six and 64 years old who received either an ADHD diagnosis or ADHD medication for up to 14 years, from between January 1, 2007 to December 31, 2022.
After analyzing the data, researchers found that each 1-year increase in the use of ADHD medication was associated with a 4 percent increased risk of cardiovascular disease, particularly within the first three years of taking the medication. The results also suggested that the risk for cardiovascular disease may be higher when taking stimulant rather than non-stimulant medications, like Strattera.
The study found that the risk for heart disease was 23 percent higher overall for people who have used ADHD medication for more than five years, compared with those who did not take medication.
“Treatment decisions, as always, should be based on carefully weighing potential benefits and risks of individual patient level, rather than simple one-size-fits-all recommendations,” the authors write. “Clinicians should be vigilant in monitoring patients, particularly among those receiving higher doses, and consistently assess signs and symptoms of [cardiovascular disease] throughout the course of treatment.”
There are approaches to treating ADHD without medication. Changes in diet as well as exercise are sometimes recommended. Cognitive Behavioral Therapy (CBT) can also be helpful. This form of psychotherapy helps patients address and change their negative thought patterns about their attention difficulties into more strategic and positive ways of thinking. The idea is that if people with ADHD can change the way they think about a situation, their behaviors and feelings will also change.
If you or someone you know is dealing with ADHD, you can find help. One place to look is the Attention Deficit Disorder Association. Use their website at https://add.org to find a directory of professionals, support groups and other resources.
The study is published in JAMA Psychiatry.