ADHD in Children
Visual Abstract
Cardiac Safety of Methylphenidate Versus Amphetamine Salts in the Treatment of ADHD
Stimulant Medications and Heart Safety in Children
Almut Gertrud Winterstein , Tobias Gerhard, Jonathan Shuster, Arwa Saidi
Summarized by:
June 30, 2023
study source
Pediatrics
July 2009
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What they studied
Do stimulant medications increase the risk of heart problems in children?
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What they found
Among over 2 million children prescribed stimulant medications, there was no evidence of higher heart problem risk.
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What this means
Stimulant medications are generally safe for children with ADHD under the supervision of a healthcare professional.
Cardiac Safety of Methylphenidate Versus Amphetamine Salts in the Treatment of ADHD
Objectives
Stimulant medications such as Adderall and Ritalin are some of the most prescribed medications for ADHD. While these medications are generally safe when used under the supervision of a professional, there are side effects. Both of these medications can affect blood pressure and heart rate.
This study wanted to examine whether individuals prescribed Adderall or Ritalin have a higher risk of heart-related emergencies.
Study Quote
Safety concerns about central nervous system stimulants for the treatment of attention-deficit/hyperactivity disorder (ADHD) include adverse cardiac effects. This study aimed to compare the risk for cardiac events in users of methylphenidate and amphetamine salts.
Methods
Researchers examined data from over 2 million children prescribed stimulant medication to see whether these medications can cause a higher risk of heart-related medical problems as measured by heart-related emergency room visits.
Study Quote
A retrospective cohort design using claims data from the Florida Medicaid fee-for-service program representing a total of 2131953 children and adolescents was used. The analysis included all beneficiaries who were between 3 and 20 years of age, enrolled between July 1994 and June 2004, h...
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Results
The results showed that generally, those on stimulant medications did not have a higher risk of visiting the emergency room for heart-related issues.
In the analysis, researchers found that those prescribed anti-depressants or antipsychotics had a higher risk of emergency room visits due to heart issues.
Study Quote
A total of 456 youth visited the ED for cardiac reasons during 52783 years of follow-up. After adjustment for differences in covariates, the risk for cardiac ED visits was similar among current users of methylphenidate or amphetamines. Periods of former use had a similar risk between you...
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Conclusions
Based on these results, researchers concluded that individuals prescribed medications were not more likely to visit the emergency room for heart issues in the study. While it is still possible that Adderall and Ritalin can cause heart issues, it’s expected that these issues are rare, given the size of this study.
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Concerns that amphetamines might have a larger propensity to cause cardiac adverse events could not be confirmed in this study. Both unadjusted and adjusted relative risk estimates did not support a pronounced risk difference between the 2 drug classes.
Similar studies have also found that ADHD medications are generally safe in adults as well:
Study Quote
Exposure to methylphenidate and amphetamines salts showed similar risk for cardiac ED visits. Additional population-based studies that address manifestation of serious heart disease, especially after long-term use, dosage comparisons, and interactions with preexisting cardiac risk factor...
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