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ADHD Medication Meta-analysis
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Visual Abstract

ADHD medications and risk of serious cardiovascular events in young and middle-aged adults

ADHD Meds & Heart Risk in Adults

Laurel A Habel , William O Cooper, Colin M Sox, K Arnold Chan, Bruce H Fireman, Patrick G Arbogast, T Craig Cheetham, Virginia P Quinn, Sascha Dublin, Denise M Boudreau, Susan E Andrade, Pamala A Pawloski, Marsha A Raebel, David H Smith, Ninah Achacoso, Connie Uratsu, Alan S Go, Steve Sidney, Mai N Nguyen-Huynh, Wayne A Ray, Joe V Selby
Summarized by:
Charles Li, MD
May 8, 2023
study source
JAMA
Dec 2011
🔎
What they studied
Researchers wanted to see whether ADHD medications such as Adderall and Ritalin increase the risk of heart attack and stroke.
👨‍🔬
What they found
After studying over 100,000 adults and over 1000 heart attacks and strokes, researchers found no evidence that ADHD medications increase cardiovascular risk.
💡
What this means
These data suggest that Adderall and Ritalin are generally safe for the heart in healthy adults if taken as directed.
ADHD Meds & Heart Risk in Adults
ADHD medications and risk of serious cardiovascular events in young and middle-aged adults

Objectives

ADHD is one of the most common psychiatric conditions in children and adults. It is commonly treated with stimulant medication, such as Adderall or Ritalin.

Since these medications cause increases in heart rate and blood pressure, some concerns have been raised about whether they can increase the risk of heart attacks and strokes.

Study Quote
Habel et al. 2011

Context: More than 1.5 million US adults use stimulants and other medications labeled for treatment of attention-deficit/hyperactivity disorder (ADHD). These agents can increase heart rate and blood pressure, raising concerns about their cardiovascular safety. Objective: To examine whet...

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Methods

This study analyzed data from four large hospital systems to see whether those taking Adderall and Ritalin had higher rates of heart attacks and strokes. They did this by comparing patients who had been prescribed these medications to similar patients who were not prescribed those medications.

Study Quote
Habel et al. 2011

Design, setting, and participants: Retrospective, population-based cohort study using electronic health care records from 4 study sites (OptumInsight Epidemiology, Tennessee Medicaid, Kaiser Permanente California, and the HMO Research Network), starting in 1986 at 1 site and ending in 20...

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Results

The researchers found no evidence of increased heart attack or stroke risk among those prescribed Ritalin or Adderall.

The results covered a large population and tracked a high number of heart attacks and strokes within the population, suggesting that the sample size was large enough to detect substantial increases in heart attack and stroke risk.

However, after adjusting for differences between those on ADHD medications and the controls, there was no evidence of any difference in risk of heart attack or stroke among those prescribed ADHD medication:

Conclusions

Based on these results, researchers concluded that there was no evidence of a higher risk of heart attack or stroke among those taking ADHD medication.

While this doesn’t prove that they are absolutely safe, it suggests that if a cardiovascular risk exists, it’s likely small and difficult to detect.

The results of this study reflect adults taking stimulant medications as directed. Stimulant medications carry significant known risks, including dependency. They are controlled substances and can be dangerous if abused.

Study Quote
Habel et al. 2011

Conclusions: Among young and middle-aged adults, current or new use of ADHD medications, compared with nonuse or remote use, was not associated with an increased risk of serious cardiovascular events. Apparent protective associations likely represent healthy-user bias.