• Posted March 27, 2024

ADHD Meds Tied to Heart Damage in Young Adult Users

ADHD stimulant medications like Ritalin or Adderall appear linked to a heightened risk for cardiomyopathy (a weakening of the heart muscle), and the risk grows with time, new research shows.

However, researchers were quick to note that cardiomyopathies are rare in the young, and even with ADHD medication use the absolute risk to any one patient remains very small.

Overall, folks ages 20 to 40 who were on a medication for attention-deficit/hyperactivity disorder (ADHD) were 17% more likely to have cardiomyopathy at one year and 57% more likely to have cardiomyopathy at eight years, compared to their peers who weren't taking the drugs. The study wasn't designed to prove cause-and-effect.

“The longer you leave patients on these medications, the more likely they are to develop cardiomyopathy, but the risk of that is very low,” said study lead author Pauline Gerard. She's a second-year medical student at the University of Colorado School of Medicine.

“I don't think this is a reason to stop prescribing these medications," she said. "There's very little increased risk of these medications over the long term; it's a real risk, but it's small.”

The findings are slated to be presented April 7 at the American College of Cardiology annual meeting in Atlanta.

The new study was based on data from 80 hospitals from across the United States, looking at people ages 20 to 40. Gerard's team compared rates of cardiomyopathy among patients with ADHD who took stimulant meds and people who were matched by age, sex and health conditions but who did not take the drugs.

The study showed that, over a period of 10 years, the relative risk for cardiomyopathy rose among people taking stimulant meds for about eight years, then tapered off during the last two years.

However, in absolute numbers, the incidence of cardiomyopathy was still quite low: At the 10-year mark, just under 1% of patients taking ADHD medications was found to have a weakened heart, Gerard's team reported.

Put another way, "you can have almost 2,000 patients on these medications for a year and you might only cause one of them to have a cardiomyopathy that they otherwise would not have had, but if you leave them on it for 10 years, 1 in 500 will have that happen," Gerard said in a meeting news release.

All of this means that doctors and patients should be aware of the risk, but no change in prescribing practices is needed, the researchers said. Testing for heart issues before prescribing ADHD medications is also probably not warranted, they said.

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

Find out more about cardiomyopathy at the U.S. National Heart, Lung and Blood Institute.

SOURCE: American College of Cardiology, news release, March 27, 2024