Pharmaceutical Research

Common attention deficit-hyperactivity disorder drugs have similar risk for emergency visits for cardiac problems

Amphetamines and methylphenidate are the two most common stimulants used to treat attention deficit-hyperactivity disorder (ADHD). In 2007, the U.S. Food and Drug Administration required that all patient medication guides for ADHD medicines contain information about the risks of taking these medicines, including cardiac events. This requirement was sparked in part because of reports linking ADHD drugs, most notably the amphetamine Adderall®, with cardiac problems.

To determine if the two stimulants were associated with cardiac events, researchers at the University of Florida in collaboration with the Center for Education and Research on Therapeutics (CERT) at Rutgers University studied data from Florida's Medicaid program. Of 30,576 youth who were newly started on either amphetamines or methylphenidate for their ADHD between January 1995 and June 2004, 456 visited the emergency department (ED) to seek care for cardiac events.

The risk of a trip to the ED was similar for youth taking either ADHD drug. Youth who visited the ED were more likely to use bronchodilators, antidepressants, or antipsychotics; have a history of circulatory or cardiac symptoms or congenital anomalies; or be 15 years or older. The authors suggest that additional studies are needed that examine long-term use and dosages to determine if ADHD drugs are linked with heart disease.

This study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS16097) to the CERT at Rutgers University. For more information on the CERTs program, visit http://www.certs.hhs.gov/.

See "Cardiac safety of methylphenidate versus amphetamine salts in the treatment of ADHD," by Almut G. Winterstein, Ph.D., Tobias Gerhard, Ph.D., Jonathan Shuster, Ph.D., and Arwa Saidi, M.B.B.Ch., in the July 2009 Pediatrics 124(1), pp. e75-e80.

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