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Use of ADHD drugs in children and young adults does not increase risk of serious cardiovascular adverse events compared with non-use

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Question

Question

Are children and young adults using attention deficit hyperactivity disorder (ADHD) medication are at increased risk for serious cardiovascular adverse events?

People

1 200 438 children and young people (aged 2–24 years; mean age 11.1 years at baseline). Patients with congenital heart disease were included.

Setting

Four health plans, USA; from 1986 to 2005.

Risk factors

Current use of ADHD medication (methylphenidate, dexmethylphenidate, dextroamphetamines, amphetamine salts, atomoxetine or pemoline). Individuals using these medications were identified from medical records, and could leave and re-enter the cohort as long as they continued to meet eligibility criteria. For each ADHD medication user up to two non-users were selected at random from the same site. Controls were matched by calendar year, age and gender and could have previous non-qualifying use of ADHD medications. Time spent in hospital and 30 days after discharge was not included as data on drugs dispensed in hospital was not available, and deaths in hospital were not an outcome of the study.

Outcomes

Serious cardiovascular event (sudden cardiac death, myocardial infarction (MI) or stroke). Potential events were identified using claims and critical records, and validated by review of all relevant medical records by two cardiologists (or two neurologists for stroke) who were blinded to exposure status, using predefined criteria. …

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