This article is more than 5 years old. Information may no longer be current.

Cardiac risks similar for two stimulants used to treat ADHD

Issue: September 2009

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

A retrospective cohort study involving more than 30,000 children and adolescents found no increased risk for cardiac emergency department visits in patients prescribed amphetamines for ADHD compared with those prescribed methylphenidate.

“Concerns that amphetamines might have a larger propensity to cause cardiac adverse events could not be confirmed in this study,” Winterstein et al wrote.

The study cohort comprised 30,576 patients aged 3 to 20 who had at least one physician diagnosis of ADHD and who had recently been prescribed methylphenidate or amphetamine salts. Data were obtained from the Florida Medicaid Fee-For-Service program.

After adjusting for covariates, including age, gender, race, history of circulatory disease, congenital anomalies and use of antidepressants, antipsychotics and bronchodilators, the risk for ED visits was similar among patients who used either medication (adjusted HR = 1.01, 95% CI 0.80-1.28). A similar risk between the two drugs was also noted for periods of former use (adjusted HR = 0.95, 95% CI 0.73-1.25).

“Although the two drug classes combined did show an increased risk for cardiac ED visits when compared with nonusers of stimulants in our previous research in the same population, the type of stimulant as evaluated in this study did not seem to affect the incidence of cardiac problems,” the researchers wrote.

The following variables were positively associated with ED visits:

• Use of bronchodilators, HR = 1.88, 95% CI, 1.40-2.53.
• Antidepressant use, HR = 1.67, 95% CI, 1.29-2.15.
• Antipsychotic use, HR = 1.90, 95% CI, 1.43-2.53.
• Age 15 and older, HR = 1.65, 95% CI, 1.26-2.16.
• History of circulatory disease or cardiac symptoms, HR = 2.72, 95% CI, 1.85-4.01.

“Additional population-based studies that address manifestation of serious heart disease, especially after long-term exposure, dosage comparisons and effects of other cardiac risk factors, are needed to inform psychiatric treatment decisions further,” the researchers wrote. – by Nicole Blazek

Winterstein AG. Pediatrics.2009;doi:10.1542/peds.2008-3138.