ADHD medications, particularly stimulants like methylphenidate and amphetamines, are widely recognized for their effectiveness in managing ADHD symptoms. However, they are also known to increase heart rate and blood pressure in the short term. With a growing number of adults being diagnosed and prescribed these medications for extended periods, questions about adherence patterns and safety, particularly potential risks of cardiovascular disease (CVD), have become increasingly relevant. As individuals with ADHD age and their risk for CVD naturally rises, robust evidence is crucial to guide safe and effective long-term treatment strategies.
Recent research from TIMESPAN sheds new light on ADHD medication usage trends and their potential health implications:
- High Discontinuation Rates: Over 50% of teens, young adults, and adults discontinue ADHD medication within a year. Among children, the rate is slightly lower at 35%. The transition to adult psychiatric care, particularly at ages 18–19, is a critical period when patients risk losing consistent care, leading to higher discontinuation rates.
- Country-Specific Patterns: Significant differences in discontinuation rates are seen across countries. For example, in Denmark, only 18% of children stop treatment within a year, compared to an average of 35% in other Nordic countries. This disparity may reflect Denmark’s stricter prescribing practices compared to countries like Sweden, where ADHD medication use is more common.
- Long-Term Cardiovascular Risks: A large-scale analysis of over 275,000 Swedish individuals revealed that long-term use of ADHD medication was associated with a 4% annual increase in cardiovascular disease risk, particularly hypertension and arterial disease. The risks were most pronounced at doses exceeding 1.5 times the defined daily dose (DDD).
Implications
These findings underscore the importance of a comprehensive approach to managing ADHD treatment, balancing symptom control with safety considerations:
- Improved Transition Support: Strengthening the transition from child to adult psychiatric care could help reduce discontinuation rates during this vulnerable period.
- Innovative Adherence Tools: Digital interventions, such as SMS reminders, could support patients in maintaining adherence to their treatment plans.
- Heart Health Monitoring: Although the absolute risk of CVD remains low, physicians should monitor cardiovascular symptoms in patients on long-term or high-dose ADHD medication.
This research emphasizes the importance of balancing the benefits of ADHD medication with a proactive approach to long-term health, ensuring patients can manage their symptoms effectively while minimizing potential risks. Patients should work closely with their healthcare providers to ensure their treatment is effective and safe, with regular follow-ups and adjustments as needed.
Read the full study details in The Lancet Psychiatry and JAMA Psychiatry.
Article was provided by Zheng Chang and Lin Li