About 2.5 million children and 1.5 million adults take stimulant medications to treat symptoms of inattention, hyperactivity and impulsivity common in attention deficit hyperactivity disorder, ADHD. In its safety report, the U.S. Food and Drug Administration issued a warning of stimulant medications that may cause cardiovascular problems, which included Focalin, Concerta, Dexedrine, Dextroamphetamine, Dextrostat, Vyvanse, Desoxyn, Metadate, Daytrana, Methylin, Ritalin, Adderall and Cylert. Although it's an uncommon side effect, there is a higher risk of cardiovascular complications in people who take stimulant medications. The FDA has discussed findings of children and adults suffering from heart attack, stroke and unexpected death while taking stimulant medication.
Concerta
The methylphenidate stimulant medication Concerta has been used to treat symptoms of ADHD in children and adults. The FDA reports that in children and adults with preexisting heart conditions, unusual heart rhythms, or heart disease, there is a increased risk of sudden death from heart complications while taking medications such as Concerta. Clinical studies of Concerta found increased heart rate and blood pressure in children and adolescents while taking the medication.
Adderall
Another commonly used stimulant medication, Adderall, carries the risk of heart complications as well, specifically in people with preexisting problems, including abnormal heart structure and heart disease. Increased heart rate and blood pressure also commonly occur in people taking Adderall. The FDA says that some patients demonstrate these changes, particularly those on higher doses of the medication. The New England Journal of Medicine reports that in one trial, the amphetamine Adderall caused a 5mmHg increase in blood pressure, with methylphenidate medications showing similar changes. This degree of impact on blood pressure can lead to increased risk of death.
Ritalin
Ritalin is another methylphenidate stimulant medication often used in the treatment of ADHD. It's described as having similar risks of cardiac complications as other stimulant medications--which include risk of sudden death, heart attack and stroke. The risk is particularly greater in people with pre-existing heart conditions. The FDA reports that in general, stimulant medications create a 2mmHg to 4mmHg increase in blood pressure and a 3bpm to 6bpm increase in heart rate. These changes can be problematic, particularly for people with current heart complications such as hypertension or arrhythmia.
FDA Study
The National Institute of Mental Health, along with the U.S. Food and Drug Administration, conducted a study of children taking stimulant medications who suddenly died as a result of heart complications. Findings showed that among children who died suddenly with no known cause as compared to sudden death due to car accident, more children who died suddenly with no known cause were using stimulant medications at that time. It's unclear of the causality of stimulant medication use based on this study alone. The FDA is conducting more extensive research to examine the risk of heart problems as a result of stimulant medication use in children and adults.
References
- U.S. Food and Drug Administration: Communication about an Ongoing Safety Review of Stimulant Medication used in Children with Attention Deficit/Hyperactivity Disorder (ADHD)
- The New England Journal of Medicine: ADHD Drugs and Cardiovascular Risk
- U.S. Food and Drug Administration: Concerta
- U.S. Food and Drug Administration: Adderall
- U.S. Food and Drug Administration: Ritalin
