What are the cardiovascular risks of psychostimulants in the treatment of attention deficit hyperactivity disorder (ADHD)?

Updated: Nov 20, 2018
  • Author: Maggie A Wilkes, MD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Psychostimulants are effective in patients with ADHD (ADD). In addition, they have been available for many decades, allowing for a strong appreciation of their lack of major adverse effects when used at therapeutic doses. However, a study published in 2014 suggests that psychostimulants may be associated with increased risk of CV events. [10, 11]

In a longitudinal, prospective cohort study of all children born in Denmark between 1990 and 1999 (mean follow-up 9.5 years), researchers found that use of psychostimulants was associated with nearly two-fold increased risk for a CV event compared with nonuse of the drugs (adjusted hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.10 - 3.04), and the risk among stimulant users with ADHD was even higher (HR, 2.34; 95% CI, 1.15 - 4.75). [10, 11] The actual cardiovascular event rate was low (84 events per 100,000 person-years), the study included a broad definition of cardiovascular events, and the use of other medications was not controlled for, making the clinical significance of the study’s findings uncertain. [10, 11]


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