Adderall and Your Heart

In 2005, a young teenage boy is rushed to the emergency room. He never leaves and is pronounced dead at the age of 15. The diagnosis? A myocardial infarction, or heart attack. The boy had been diagnosed at the age of 6 with Attention Deficit Hyperactivity Disorder, or ADHD. He was on several medications throughout his childhood and teen years. Most recent had been Adderall. Death was believed to be caused by Adderall. It was the first reported case of death by a person who had not overdosed or misused the drug. The event caused Canadian pharmacies to pull the drug and limit children who were taking it. It also launched an investigation by the FDA.

Adderall has been a long time prescribed drug for children and adults who suffer from Attention Deficit Disorder (ADD) or ADHD. Adderall is a Dextroamphetamine/Amphetamine mixture. While previously used in the treatment for weight loss, in March of 1996 it became approved for the treatment of ADHD and ADD. Because it is considered a narcotic, Adderall carries a large warning sign including the risk of dependence, and if misused possible adverse cardiovascular effects. Overdose side effects could include: abnormal ECG, (a test to determine heart function), high blood pressure, rapid heart beat, muscle pain and even kidney damage.

In the past several years, deaths linked to Adderall have increased. Among them, children who were taking the doses at the prescribed levels. 20 deaths were reported in Canada among Adderall users, and 12 suffered strokes. Several years later after pulling the drug off the market Canada is now selling Adderall again. But this time the little black box has added a new warning to users that "even the usual, recommended doses of Adderall^® have led to deaths and heart attacks in some people." Before, the warnings only carried the risk if a person overdosed on the medication.

The United States now carries that same warning on all bottles of Adderall. But even after several deaths, it hasn't seemed to deter many users. In fact, Adderall sales have risen 16% this year according to the maker of the drug, Shire. (Health, 2008). In September of this year, US News and World Report released an article recommending those children encouraged to take prescription stimulant medications to first undergo a cardiovascular screening. It involves taking an ECG (or electrocardiogram) test; a painless five minute test that could determine if their are any underlying heart conditions or problems prior to starting medication. It is thought that this could potentially lower the risk of children suffering from cardiovascular problems while taking the medication.

However, many users of the drug are adults. Approximately 1.5 million adults are prescribed medication for the treatment of ADHD and ADD. Most often, adults need a smaller dose according to his or her weight due to the longer "half-life" of the pill in their body. In 2006, 51 deaths had been reported among children and adults who took medications like Adderall. That same year, the FDA warned users of the drug to periodically monitor blood pressure, and cardiovascular health. Unfortunately, that hasn't passed down to medical professionals and adult users of Adderall, who could potentially be at more risk. As adults age, the risk of heart disease increases, especially in those who have a family history of the disease. Adults as they age also add more weight, and blood pressure increases.

As of yet, recommendations for receiving an ECG have only been given to children and teens. And the ECG is recommended to be taken only prior to beginning medications. What does that mean for adults who never received a thorough heart screening prior to taking medication as a child, teen, or even their adult years before starting the medication?

The most important thing to do if you are taking the medication is to have your blood pressure and pulse periodically checked to make sure it is within normal limits. You may also want to talk with your doctor to see if you may benefit from having an ECG test done, especially if you have a history of heart murmur, palpitations, or family history of heart disease. You may benefit from yearly evaluation of your medication you are taking to reevaluate the dosage and to keep it at a dose that is safe and tolerable for you.

Adderall has shown to have incredible benefits for those suffering from ADD and ADHD. However, like most medications it should be used with caution. If you have been taking this medication for an extended period of time, or have even just recently started make sure you are taking the precautions needed to keep yourself and your heart healthy.