Children and Young Adults Who Used Medication for Attention Deficit Hyperactivity Disorder Faced Increased Cardiac Risks

Abstract

Aim: There have been concerns about links between medication for attention deficit hyperactivity disorder (ADHD) and cardiac events in children and young people. Our aim was to identify any associations.

Method: This Swedish case-control study used national register data to identify individuals aged 5-30 years who received their first diagnosis of a cardiac arrest, arrhythmia, fainting or collapse in 2006-2018. Each case was matched with five controls, by age, sex and region. Associations between ADHD medication and cardiac events were assessed using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adjustments were made for concomitant medications and comorbidities, including congenital heart disease (CHD).

Results: We studied 112 605 cases (57.9% female), with a median age of 20 years (range 5-30), and 563 024 matched controls. Using ADHD medication was associated with cardiac events (aOR 1.63, 95% CI 1.47-1.81) across sexes and age groups. Undefined arrhythmias had the strongest association (aOR 2.66, 95% CI 2.27-3.13). Cardiac arrests and defined arrhythmias had no associations. Long-term medication was associated with an increased risk (aOR 1.20, 95% CI 1.12-1.28). CHD had no impact.

Conclusion: ADHD medication was associated with cardiac events, particularly undefined arrhythmias. CHD did not increase the risk.

Keywords: arrhythmia; attention deficit hyperactivity disorder; cardiac arrest; fainting; medication.