Two new studies led by researchers from Karolinska Institutet provide valuable insights into the patterns of ADHD medication use and its potential cardiovascular risks.
Two new studies led by researchers from Karolinska Institutet provide valuable insights into the patterns of ADHD medication use and its potential cardiovascular risks.
Published in The Lancet Psychiatry and JAMA Psychiatry, these studies highlight the challenges of sustained ADHD medication use, especially among young adults, and indicate a potential link between long-term and high-dose ADHD medication and an increased risk of certain cardiovascular diseases.
In the multinational study published in The Lancet Psychiatry, researchers analyzed prescription data from over 1.2 million patients who initiated ADHD medication in various countries, including Australia, Denmark, Hong Kong, Iceland, the Netherlands, Norway, the UK, Sweden, and the USA.
The findings revealed that more than half of teenagers, young adults, and adults discontinued ADHD medication within the first year. Among children, on behalf of whom decisions are often made by parents or guardians, 35% stopped medication within a year. The highest discontinuation rate occurred among 18 to 19-year-olds, raising concerns about the transition from child and adolescent psychiatry to adult psychiatry.
According to Zheng Chang, senior researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, the high rate of early discontinuation may pose a significant barrier to effective ADHD treatment. Reasons for discontinuation include adverse reactions and perceived lack of effectiveness, but the direct causes require further analysis.
The study also highlighted Denmark as an outlier with a lower proportion (18%) of children discontinuing treatment within a year, suggesting differences in prescription practices and the severity of ADHD cases.
In a separate study published in JAMA Psychiatry, researchers examined over 275,000 Swedish ADHD patients over a period of up to 14 years. The study suggested a potential association between long-term and high-dose ADHD medication and an elevated risk of certain cardiovascular diseases, primarily hypertension and arterial disease.
The risk increased by approximately four percent annually, with the highest risk in the initial years of treatment. Significantly, the risk was only statistically significant at doses exceeding 1.5 times the average daily dose.
Le Zhang, postdoc researcher in Dr. Chang’s research group, emphasized that while there is an increased risk of cardiovascular disease associated with long-term use of ADHD medication, patients should not be alarmed. The benefits of treatment should be carefully considered on a case-by-case basis, and regular follow-ups are essential to monitor signs and symptoms of cardiovascular disease.
It’s important to note that these studies are observational, and a direct causal link between ADHD medication and cardiovascular risks cannot be established. Other factors such as concurrent medications, symptom severity, or lifestyle choices could contribute to the observed associations.
These studies underscore the need for improved strategies for ADHD medication management, including addressing the challenges of early discontinuation and ensuring appropriate follow-up care. The findings also emphasize the importance of personalized approaches in weighing the benefits and potential risks of long-term ADHD medication use.