Researchers have just debunked concerns that stimulant medication could be dangerous to cardiac health.
In many cases, children especially have been prevented from getting the help they needed due to concerns that stimulant medications – like methylphenidate (Ritalin, Metadate, Focalin, Concerta) or dextroamphetamine (Dexadrine, Adderall) – could harm the heart.
A retrospective analysis led by William Cooper, MD, MPH of Vanderbilt University in Nashville, TN and his colleagues showed no significant increase in risk of sudden death, cardiovascular event, MI or stroke among young current or former patients who were prescribed stimulant medication to treat ADHD, as compared with a control group.
The study was reported in the New England Journal of Medicine.
Researchers noted in their study, however, that the upper limits of the 95% confidence intervals for current and former users “indicated that the doubling of the risk couldn’t be ruled out.” Even then, however, the absolute magnitude of such an increased risk would be low, they wrote.
Stimulant medications have been used to treat attention deficit hyperactivity disorder (ADHD) in children, teens and adults since the 1950s.
But a case-controlled study in 2009 found a small statistical risk of serious cardiovascular events in children who were prescribed the medication. Reports of cases of sudden unexplained death among children taking stimulants to treat their ADHD raised concerns.
The study, conducted by a team led by Madelyn Gould, Ph.D., M.P.H. Of the New York State Psychiatric Institute (NYSPI) and New York City’s Columbia University, was reported online in The American Journal of Psychiatry.
However, the authors of the study also noted that the study design itself also prohibited conclusions to be drawn about causality, and said there was not enough information to determine whether in fact the subject children in the study who were taking the stimulants had ADHD.
The FDA, which partially funded the study, also said it was impossible to conclude that the data from the study affected the overall risk and benefit profile of stimulant medications used to treat ADHD in children.
Nevertheless, the FDA ordered a black box warning to note an increased risk of sudden cardiac death with the class. The American Heart Association also considered it “reasonable” for children taking medication for ADHD to undergo an echocardiogram.
Both precautions have since been changed: The AHA revised its recommendations following preliminary results from studies that were published in April 2011, and the FDA announced the medication does not need additional labeling.