Fears over long-term effects of Adderall as study suggests drug can cause fatal heart damage

Doctors have issued a warning about the long-term effects of Adderall after a study suggested the meds may cause heart damage.

Researchers from the University of Colorado looked at Americans between the age of 20 and 40 who were prescribed Adderall or Ritalin for their ADHD.

They found patients were nearly 60 percent more likely to have a weakened heart eight years after taking them compared with people who also had ADHD but who are not taking those medications.

The stimulant drugs work by altering levels of chemicals in the brain to enhance concentration and focus, but there are concerns they can also elevate blood pressure by causing the heart to beat faster and with greater force.

Over time this can weaken the heart and lead to the heart muscle becoming thicker, stiffer and larger. This can cause an irregular heartbeat, heart failure, or a life-threatening condition called cardiac arrest.

The above chart shows ADHD rates in the US compared to other countries

It comes amid fears that ADHD is being over diagnosed and the powerful stimulants used to treat it overprescribed. 

One in seven boys aged 5 to 17 now have attention-deficit hyperactive disorder in the US, a recent report suggested.

The drugs have other nasty side effects, including insomnia, increased irritability and anxiety. In serious cases, they can cause seizures, hallucinations and psychosis.

Researchers at the University of Colorado emphasized that the overall risk of cardiomyopathy – a weakening of the heart muscle which reduces its ability to pump blood around the body – stayed ‘relatively low’, even when stimulants were used long-term.

The academics said their findings do not necessarily point to a need for clinicians to change their approach to screening patients for the development disorder or prescribing the medications.

For example to put into context, after being prescribed stimulants for 10 years, just 0.72 percent (less than three-quarters of one percent) of patients developed cardiomyopathy, compared with 0.53 percent (a little over half of one percent) among those who were not prescribed stimulants.

In some cases of cardiomyopathy, the heart rhythm becomes disturbed, which leads to arrhythmias (irregular heartbeats).

Long-term risks arrhythmias include life-threatening stroke, heart failure, or cardiac arrest. 

Researchers from the University of Colorado found that people prescribed stimulants such as Adderall and Ritalin were 57 percent more likely to have a weakened heart eight years after taking them, compared with those not taking these medications

Using data from around 80 hospitals in the US, the researchers analyzed information from people diagnosed with ADHD aged between 20 and 40.

People with heart damage caused by other known factors, such as cancer treatments, were excluded.

The researchers paired each person who had been prescribed stimulants with someone who had not been but was similar in other aspects such as age, sex and health conditions, and also had ADHD.

In total, 12,759 pairs were created and were followed for at least 10 years.

People who were on a medication of ADHD were 17 percent more likely to have cardiomyopathy after one year of taking the drugs, the study found.

And 57 percent among those on drugs of eight years were more likely to have a weakened heart.

Despite the gap, the prevalence of cardiomyopathy was still quite low in both groups.

Pauline Gerard, a second-year medical student at the University of Colorado School of Medicine in Aurora, Colorado, and the study’s lead author, put the numbers in context: ‘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.’

Ms Gerard added: ‘The longer you leave patients on these medications, the more likely they are to develop cardiomyopathy, but the risk of that is very low.

‘I don’t think this is a reason to stop prescribing these medications. There’s very little increased risk of these medications over the long term; it’s a real risk, but it’s small.’

The rising rates of ADHD comes amid psychologists’ warnings that prevalence in the in the US is far too high — and is causing many children to needlessly take drugs used to treat the condition.

The market value for ADHD medications such as Adderall and Ritalin more than tripled over the 12 years to 2022 to $12.5billion. Estimates suggest it could hit nearly $15billion by 2030. 

The late Dr Keith Connors was a former Harvard University psychologist who published the first standards for diagnosing ADHD in the 1990s.

‘The numbers make it look like an epidemic’, he said in 2013, five years before his death. ‘Well, it’s not. It’s preposterous.

‘This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.’

ADHD is defined as a neurodevelopmental disorder that affects an individual’s ability to focus, control impulses and regulate  energy levels.

It is typically diagnosed in childhood, around the ages of six or seven years, but in many cases persists into teen years and adulthood.