No Worries With ADHD Meds

If you number yourself among the one in twenty-five American adults who has ADHD, you don't need to worry that the most common medications used to manage the condition are hurting your heart.  Good news! as I say in this week's YouTube, and Rick and I agree in the podcast.  That's according to a study in the Journal of the American Medical Association.

Previous worries about modestly increased heart rate and blood pressure related to use of a few commonly prescribed medications for ADHD caused some of these very useful agents to be restricted or removed from the market.  This very large study lays to rest some of those concerns.  Here's what they did:

Over 150,000 adult users of the ADHD medications methylphenidate, amphetamine, atomoxitine or pemoline were matched to two nonusers from the same study site, age, gender, and calendar year during which data was collected.  The sites included California, Tennessee, and two national databases.  Adult users were between the ages of 25 and 64.

Medication use was determined by prescription fills from electronic pharmacy records.  Usage was defined as current, indeterminate, former use or nonuse.  Analysis was also performed for current versus remote use, where a subject had stopped using the medication 365 days or more ago.

Strokes and cardiac events, including sudden cardiac death and possible myocardial infarctions, were correlated with use of an ADHD medication. No increased risk of these outcomes was seen in any group of ADHD medications users, nor was an increased risk seen comparing current to remote use.  No one medication emerged as risky, and long term use did not appear to be correlated with increased risk of cardiac events or stroke.   That's a relief to the millions of people who are taking these drugs, we're sure, and as Rick points out in the podcast, agrees well with a study we've discussed previously establishing the safety of these medications in children as well.

The most commonly used among the ADHD medications in this study was methylphenidate, used by 45% of subjects, closely followed by the amphetamines at 44% of subjects.  Atomoxitine accounted for 8% of use, and 4% used pemoline.  Methylphenidate and the amphetamines have been around for quite some time and are known to be effective, with about 70% of people who take them responding.  The advantage to atomoxitine and pemoline is they're not stimulants, but they too have their side effects.  No doubt having a few choices is good for those who don't respond to one medication or can't tolerate the side effects.

In short, Rick and I agree that this study should reassure folks with ADHD that they can take their medications safely.  As the number of people with the condition is so large, that's good news for all of us.  Other studies this week include the safety of have a stent placed in a hospital that doesn't do bypass surgery, and getting a handle on the cause of stillbirths, also in JAMA, and in NEJM,a way to possibly reduce transfusions after elective surgery.  Until next week, y'all live well.

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No Worries With ADHD Meds — PodBlog | Healthcare News |
December 19, 2011 at 11:57 am
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