New Study on ADHD Drugs Warns of Cardiovascular Risk

CCHR says some of the 9.5 million Americans, including 3.1 million children taking ADHD drugs long-term may be in danger of heart disease, study confirms

By CCHR International
The Mental Health Industry Watchdog
December 1, 2023

With over 9.5 million Americans taking prescription drugs for Attention Deficit Hyperactivity Disorder (ADHD), a new study featured in JAMA Psychiatry serves as a compelling wake-up call regarding the long-term use of these drugs. The Citizens Commission on Human Rights International, a mental health industry watchdog, underscores the significance of these findings. Conducted by Swedish researchers, the study reveals a 23% increase in the risk of heart disease among individuals using ADHD drugs for more than five years compared to those who did not. The researchers tracked individuals diagnosed with ADHD, ranging from ages 6 to 64, for an average period of four years, with some cases spanning up to 14 years between January 2007 and December 2020.[1]

The study specifically identifies stimulant drugs as being associated with a higher risk of heart-related issues. The research underscores the gravity of the situation by quantifying the impact: each additional year of ADHD drug use was linked to an average 4% elevation in the risk of heart disease, as concluded by the researchers.[2]

CCHR actively monitors the adverse effects of psychiatric drugs and has acquired access to IQVia’s Total Patient Tracker Database for 2020, which reports that 3,155,441 individuals aged 0–17 were prescribed these drugs.[3]

The Food and Drug Administration (FDA) has approved the use of two categories of psychoactive drugs—stimulants and non-stimulants—in children starting at the age of 6.[4] It is noteworthy that below this age, these drugs are not approved. Yet, IQVia statistics reveal that 58,091 children aged 5 and younger were prescribed ADHD drugs in 2020.

In February 2022, Harvard Health Publishing also pointed to new research suggesting the drugs may cause a short-term spike in the risk of heart attacks, strokes, and heart rhythm disorders (arrhythmias). The findings make sense since stimulants cause the heart to beat faster and with greater force, both of which can raise blood pressure, said Dr. Pieter Cohen, an associate professor of medicine at Harvard Medical School. He referred to a study involving more than 6,400 people ages 66 and older who started stimulant prescriptions between 2017 and 2019. On average, stimulant users were 40% more likely to end up in the emergency room or hospital with a serious heart complication within 30 days of starting the drug.[5] IQVia reported 340,118 Americans aged 65 years and over taking “ADHD” drugs.

The concern about heart risks has been longstanding. On February 9, 2006, an FDA committee voted to recommend a black box warning, the FDA’s most serious warning, for the stimulant Concerta concerning the increased risk of severe cardiovascular events. Several scientific studies have found an increase in the rates of hospitalization for cases of myocardial infarction, stroke, and sudden death in children and adults taking Concerta. Between 1999 and 2003, there were 54 reports of non-fatal cardiovascular events and 25 deaths, 19 of which were children, in patients who were taking Concerta.[6]

CCHR says psychiatrists and doctors are taking enormous risks when prescribing these drugs which are also linked to psychosis, addiction, and suicide.[7]

The four FDA-approved non-stimulants include Strattera (atomoxetine), Intuniv (guanfacine), Kapvay (clonidine) and Qelbree (viloxazine).[8] Atomoxetine’s label includes a black box warning for suicidal ideation.[9] Since 2015, Health Canada has had a suicide warning for all methylphenidate drugs (stimulants), as well as for the non-stimulants Intuniv XR (guanfacine extended release), Strattera, Vyvanse (lisdexamfetamine dimesylate), Dexedrine (dextroamphetamine sulfate) and Adderall XR (mixed salts amphetamine extended-release).[10] Drugs.com specifically indicates “Do not give Kapvay to a child younger than 6 years old.”[11]

The problem is exacerbated by how subjectively ADHD is diagnosed. There are no brain scans, blood or urine tests, or other medical examinations to determine it. Behaviors on ADHD questionnaires have been criticized because anyone could fall prey to a diagnosis. Symptoms for children and adolescents include:

“Often fails to give close attention to details or makes careless mistakes in school work….”
“Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort….”
“Often fidgets with or taps hands or feet or squirms in seat.”
“Often unable to play or engage in leisure activities quietly.”

For Adult ADHD, alleged symptoms include impulsiveness, disorganization, and problems prioritizing, poor time management skills, problems focusing on a task, trouble multitasking, excessive activity or restlessness, poor planning, low frustration tolerance, hot temper, and trouble coping with stress.

Adult ADHD emerged as a thriving market for drug manufacturers, as highlighted by Fierce Pharma in 2015. Their report indicated that the utilization of ADHD drugs among adults in the U.S. was expanding at a rate almost twice as fast as the overall market growth. Shire Pharmaceuticals, the maker of Vyvanse, reported that 53% of prescriptions for ADHD drugs in 2014 were for adults, up from 39% in 2007, and amounted to 63 million prescriptions the previous year. This churned out $1.4 billion in sales in 2014.[12]

On August 28, 2023, the FDA approved several generic forms of Vyvanse. Fourteen companies had the go-ahead to manufacture and sell generic versions of Vyvanse capsules and chewable tablets, according to the FDA. As of this date, it is estimated that one million Americans regularly take Vyvanse, generating $2.5 billion in sales annually.[13]

This is a small fraction of the ADHD drug sales that have reached

$20 billion a year in the U.S. alone.[14] With it has come fraudulent marketing to increase sales. Between 2000 and 2013, the FDA cited every major ADHD drug manufacturer for false and misleading advertising—some multiple times.[15] In February 2013, Shire agreed to pay $57.5 million in fines to resolve allegations of improper sales and advertising of several drugs, including Adderall XR, Vyvanse, and Daytrana, the latter a patch that delivers the stimulant through the skin.[16]

CCHR emphasizes the need for a shift in the mental health system’s biomedical model, urging a departure from drugs that carry risks such as psychosis, addiction, cardiac issues, and suicide. As the recent guidelines from the World Health Organization and the United Nations on mental health urges, “there is an overreliance on biomedical approaches and treatment options and inpatient services” and laws should “transition away from a narrow emphasis on biomedical approaches.”[17] According to CCHR, the warnings associated with these drugs serve as additional evidence supporting the necessity for this paradigm shift.

[1] Deidre McPhillips, “People taking ADHD medications should closely monitor their heart health, study suggests,” CNN, 22 Nov. 2023, https://www.cnn.com/2023/11/22/health/adhd-medication-heart-disease-risk-wellness/index.html; Zhang, et al., “Attention Deficit/Hyperactivity Disorder Medications and Long-Term Risk of Cardiovascular Diseases,” JAMA Psychiatry, 22 Nov. 2023, https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2811812?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=
jamapsychiatry.2023.4294

[2] Ibid., Deidre McPhillips, CNN, 22 Nov. 2023

[3] https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/

[4] https://www.fda.gov/consumers/consumer-updates/treating-and-dealing-adhd

[5] https://www.health.harvard.edu/heart-health/how-stimulants-may-affect-your-heart

[6] https://www.impactlaw.com/dangerous-drugs/concerta

[7] https://www.cchrint.org/2022/10/07/cchr-warns-children-labeled-adhd/; Patrick Hahn, “ADHD: The Money Trail,” Mad In America, 4 May 2022, https://www.madinamerica.com/2022/05/adhd-money-trail/

[8] https://www.fda.gov/consumers/consumer-updates/treating-and-dealing-adhd

[9] https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021411s035lbl.pdf

[10] https://www.cbc.ca/news/health/adhd-drugs-to-add-suicide-risk-warnings-1.3015562

[11] https://www.drugs.com/clonidine.html

[12] https://www.fiercepharma.com/pharma/adults-are-now-prime-market-for-adhd-drugs-u-s