6 ms·

ADHD Stimulants May Increase Risk of Heart Damage in Young Adults

42 points by Gerlo 2y ago

therein 2y ago
Water makes you wet. Also not very significantly: > You can have almost 2,000 patients on these medications for a year and you might only cause one of them to have a cardiomyopathy that they otherwise would not have had, but if you leave them on it for 10 years, 1 in 500 will have that happen.
- Vecr 2y ago
  It's in "young adults", so that's still ~10 plus times more than from the Pfizer COVID-19 vaccine. Absolutely not zero.
joecool1029 2y ago
Will be interesting to see the paper when it's out. I am wondering if they collected dosage in the study. I could see the risk going up if in 8 years some of the study group ramped up dosage to top end of the therapeutic range. I don't think anyone's surprised that high dose and/or misuse of stimulants can cause heart damage.
saulrh 2y ago
Stimulants bring so many other benefits that the risks of cardiomyopathy are outweighed even within their narrow slice of outcomes: taking stimulants reduces non-psychiatric hospital admissions in attention disorder subjects by up to 40%, with stronger stimulants showing stronger protection. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816499 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
ttul 2y ago
Despite the increase in cardiac risks, stimulant medications remain the most effective treatment for ADHD in adolescents. “Treatment with ADHD medications reduces accidental injuries, traumatic brain injury, substance abuse, cigarette smoking, educational underachievement, bone fractures, sexually transmitted infections, …” ADHD is associated with a litany of negative consequences if left untreated. An increase in the risk of a rare cardiac issue seems trivial next to the well documented risks of not treating this condition as effectively as possible. https://pubmed.ncbi.nlm.nih.gov/33549739/ https://pubmed.ncbi.nlm.nih.gov/33549739/
- anemoiac 2y ago
  The "Oh, well everyone has a little bit of ADHD..." opinion seems to be fairly popular, perhaps due to the increasing ubiquity of digital distractions we all encounter daily, but reading just a small amount of actual research led me to the conclusion that this is completely misguided and "real" ADHD (whatever that is) has likely left a significant amount of its victims dead, in prison, or terminally drug-addicted. One simple example that supports this conclusion can be found in driving (the most dangerous routine activity most people engage in?), where stimulant medication significantly improves outcomes for those with ADHD. I don't have specific links handy, but a simple Google search (https://www.google.com/search?q=adhd+medication+driving+safety https://www.google.com/search?q=adhd+medication+driving+safe...) will offer ample confirmation.
  - throwaway11460 2y ago
    Haha yeah, it's funny. I take a little stimulant and suddenly the insatiable urge to go over 200 km/h is completely gone, I don't scream at anyone, I don't rage at all any more. Now I just wait a little and listen to my music, no problem at all. The funniest thing is how it all comes back once I'm 2 days off the meds, though.
    - eqvinox 2y ago
      Yeah I produced 3 car accidents off-meds. The last of them almost killed my girlfriend at the time. Since that, I don't drive off-meds anymore (and have had no further issues). Sadly, the authorities would rather have the reverse, with driving under the influence of MPH being in a legal grey zone (at least where I live.) This IMHO needs to be fixed ASAP.
eqvinox 2y ago
How is this news? Monitoring heart condition is part of ADHD medication management day 1? confused
- bun_terminator 2y ago
  yeah, this was the reason I had to stop. Because the doc said "you'll need to have a cardiac report next time or you won't get new pill" to an ADHD patient with no organizational skills. I never went again unfortunately. Oh how I miss it
  - fgkramer 2y ago
    I’m in my first month of meds and I’d do anything that’s necessary to keep taking them. I get it’s a catch 22 sometimes, especially trying to get diagnosed as an adult, but the benefits in my life have been immense. I’d encourage you to muster the willpower (that we feel we lack so often) and book it if you can afford it. It took me years to get to this point and I wish I had done it sooner. Life is short, allow yourself to live it fully!
    - bun_terminator 2y ago
      It's been many years now, there's no fixing anymore. The upwards trajectory stopped of course, but two years or so I got were enough to get me through college, into an okay job and even help me find a girlfriend. It's not ideal, but I'll live.
  - eqvinox 2y ago
    Man that sucks. Luckily where I live they just do it right there. Hope you can find some energy and space to get it straightened out :(
Swordfish12345 2y ago
I would love to see a study on how banning social media impacts ADHD symptoms. The current wisdom is as soon as a diagnosis is made: go straight on the meds because there is minimal side-effects. So environmental modifications as treatment are not explored. Plus, once meds are involved, you now have a stimulant dependence to deal with too involving a afternoon crash, and increased anxiety, etc. Then your on anti-depressants to counteract these side-effects, etc. etc. I was listening to the All-In podcast and Chamath's child got a diagnosis recently, and they said: absolutely no meds. Then took his iPad away and symptoms decreased dramatically.
- Llamamoe 2y ago
  Sure, in light cases it might help, but mostly you see news/social media amplifying ableistic "look at <other people with>, they're managing, why aren't you? it's obviously your lifestyle choices" But talk to any people who actually have ADHD and you'll realize that this doesn't help anyone: ADHD doesn't mean "easily distracted", it means "inability to maintain control over focus", and taking distractions away doesn't make this even marginally less impactful. You might be more likely to come back to a task instead of getting lost in distractions, but it's never gonna be enough for anyone but the lightest cases and misdiagnoses. Just stop trying to decide how people should treat their disabling medical conditions. You've got millions saying "stimulants are the only thing that helped", and yet every time the topic of ADHD comes up, someone goes "hmm but maybe we shouldn't give people stims, and force them to use self-control they don't have to stop having ADHD ??"
  - StefanBatory 2y ago
    If someone had a broken arm you wouldn't tell them to exercise that arm more and that it's fine. Or that back in time people didnt had casts and they were fine. I don't understand why so many people act otherwise when it does come to issues you can't see. I don't have ADHD but I have friends who do. And no it's not a question of willpower they need meds to function. So I'm very sensitive when it comes to people saying it's on them like poster before you somewhat implies. :(
instagraham 2y ago
is there a greater likelihood of substance abuse and smoking in ADHD individuals without stimulant medication? If meds still offset that risk, meds are still a better option. Everything is a choice between evils.
- yungporko 2y ago
  yes there is
- eqvinox 2y ago
  > is there a greater likelihood of substance abuse and smoking in ADHD individuals without stimulant medication? Yes, as well as self-endangering (both thrill-seeking as well as suicidal) behavior and unwanted pregnancies.
throwaway11460 2y ago
Well, yes? That's the number one thing written on the box. My doctor checks my heart every month, and we discussed this trade off extensively.
Zetobal 2y ago
Who would have thought that meth(lite) could do that.
dsq 2y ago
The names of the drugs are not mentioned in the article. What are they?

42 points by Gerlo 2y ago

Water makes you wet. Also not very significantly: > You can have almost 2,000 patients on these medications for a year and you might only cause one of them to have a cardiomyopathy that they otherwise would not have had, but if you leave them on it for 10 years, 1 in 500 will have that happen.

Vecr 2y ago
It's in "young adults", so that's still ~10 plus times more than from the Pfizer COVID-19 vaccine. Absolutely not zero.

joecool1029 2y ago

Will be interesting to see the paper when it's out. I am wondering if they collected dosage in the study. I could see the risk going up if in 8 years some of the study group ramped up dosage to top end of the therapeutic range. I don't think anyone's surprised that high dose and/or misuse of stimulants can cause heart damage.

saulrh 2y ago

Stimulants bring so many other benefits that the risks of cardiomyopathy are outweighed even within their narrow slice of outcomes: taking stimulants reduces non-psychiatric hospital admissions in attention disorder subjects by up to 40%, with stronger stimulants showing stronger protection. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816499 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

ttul 2y ago

Despite the increase in cardiac risks, stimulant medications remain the most effective treatment for ADHD in adolescents. “Treatment with ADHD medications reduces accidental injuries, traumatic brain injury, substance abuse, cigarette smoking, educational underachievement, bone fractures, sexually transmitted infections, …” ADHD is associated with a litany of negative consequences if left untreated. An increase in the risk of a rare cardiac issue seems trivial next to the well documented risks of not treating this condition as effectively as possible. https://pubmed.ncbi.nlm.nih.gov/33549739/ https://pubmed.ncbi.nlm.nih.gov/33549739/

anemoiac 2y ago
The "Oh, well everyone has a little bit of ADHD..." opinion seems to be fairly popular, perhaps due to the increasing ubiquity of digital distractions we all encounter daily, but reading just a small amount of actual research led me to the conclusion that this is completely misguided and "real" ADHD (whatever that is) has likely left a significant amount of its victims dead, in prison, or terminally drug-addicted. One simple example that supports this conclusion can be found in driving (the most dangerous routine activity most people engage in?), where stimulant medication significantly improves outcomes for those with ADHD. I don't have specific links handy, but a simple Google search (https://www.google.com/search?q=adhd+medication+driving+safety https://www.google.com/search?q=adhd+medication+driving+safe...) will offer ample confirmation.
- throwaway11460 2y ago
  Haha yeah, it's funny. I take a little stimulant and suddenly the insatiable urge to go over 200 km/h is completely gone, I don't scream at anyone, I don't rage at all any more. Now I just wait a little and listen to my music, no problem at all. The funniest thing is how it all comes back once I'm 2 days off the meds, though.
  - eqvinox 2y ago
    Yeah I produced 3 car accidents off-meds. The last of them almost killed my girlfriend at the time. Since that, I don't drive off-meds anymore (and have had no further issues). Sadly, the authorities would rather have the reverse, with driving under the influence of MPH being in a legal grey zone (at least where I live.) This IMHO needs to be fixed ASAP.

eqvinox 2y ago

How is this news? Monitoring heart condition is part of ADHD medication management day 1? confused

bun_terminator 2y ago
yeah, this was the reason I had to stop. Because the doc said "you'll need to have a cardiac report next time or you won't get new pill" to an ADHD patient with no organizational skills. I never went again unfortunately. Oh how I miss it
- fgkramer 2y ago
  I’m in my first month of meds and I’d do anything that’s necessary to keep taking them. I get it’s a catch 22 sometimes, especially trying to get diagnosed as an adult, but the benefits in my life have been immense. I’d encourage you to muster the willpower (that we feel we lack so often) and book it if you can afford it. It took me years to get to this point and I wish I had done it sooner. Life is short, allow yourself to live it fully!
  - bun_terminator 2y ago
    It's been many years now, there's no fixing anymore. The upwards trajectory stopped of course, but two years or so I got were enough to get me through college, into an okay job and even help me find a girlfriend. It's not ideal, but I'll live.
- eqvinox 2y ago
  Man that sucks. Luckily where I live they just do it right there. Hope you can find some energy and space to get it straightened out :(

Swordfish12345 2y ago

I would love to see a study on how banning social media impacts ADHD symptoms. The current wisdom is as soon as a diagnosis is made: go straight on the meds because there is minimal side-effects. So environmental modifications as treatment are not explored. Plus, once meds are involved, you now have a stimulant dependence to deal with too involving a afternoon crash, and increased anxiety, etc. Then your on anti-depressants to counteract these side-effects, etc. etc. I was listening to the All-In podcast and Chamath's child got a diagnosis recently, and they said: absolutely no meds. Then took his iPad away and symptoms decreased dramatically.

Llamamoe 2y ago
Sure, in light cases it might help, but mostly you see news/social media amplifying ableistic "look at <other people with>, they're managing, why aren't you? it's obviously your lifestyle choices" But talk to any people who actually have ADHD and you'll realize that this doesn't help anyone: ADHD doesn't mean "easily distracted", it means "inability to maintain control over focus", and taking distractions away doesn't make this even marginally less impactful. You might be more likely to come back to a task instead of getting lost in distractions, but it's never gonna be enough for anyone but the lightest cases and misdiagnoses. Just stop trying to decide how people should treat their disabling medical conditions. You've got millions saying "stimulants are the only thing that helped", and yet every time the topic of ADHD comes up, someone goes "hmm but maybe we shouldn't give people stims, and force them to use self-control they don't have to stop having ADHD ??"
- StefanBatory 2y ago
  If someone had a broken arm you wouldn't tell them to exercise that arm more and that it's fine. Or that back in time people didnt had casts and they were fine. I don't understand why so many people act otherwise when it does come to issues you can't see. I don't have ADHD but I have friends who do. And no it's not a question of willpower they need meds to function. So I'm very sensitive when it comes to people saying it's on them like poster before you somewhat implies. :(

instagraham 2y ago

is there a greater likelihood of substance abuse and smoking in ADHD individuals without stimulant medication? If meds still offset that risk, meds are still a better option. Everything is a choice between evils.

yungporko 2y ago
yes there is
eqvinox 2y ago
> is there a greater likelihood of substance abuse and smoking in ADHD individuals without stimulant medication? Yes, as well as self-endangering (both thrill-seeking as well as suicidal) behavior and unwanted pregnancies.

throwaway11460 2y ago

Well, yes? That's the number one thing written on the box. My doctor checks my heart every month, and we discussed this trade off extensively.

Zetobal 2y ago

Who would have thought that meth(lite) could do that.

dsq 2y ago

The names of the drugs are not mentioned in the article. What are they?