'Study-Enhancing Drug' Myth: ADHD Medication Causes Cardiovascular Disease in Children

Latest Issue of JAMA Research Findings
Increased Risk of Hypertension and Arterial Disease from Children to Adults
Specialist: "Adolescent Misuse Can Harm Lifelong Health"

A study has found that attention deficit hyperactivity disorder (ADHD) medications increase the risk of cardiovascular diseases such as hypertension and arterial disease. ADHD is a disorder characterized by inattention, distractibility, and impulsive behavior during childhood. About 5% of elementary school students in Korea exhibit symptoms, and many continue to experience symptoms into adulthood. In Korea, there are concerns that ADHD medications are being misused as concentration-enhancing drugs by college entrance exam candidates.

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A research team from the Karolinska Institute in Sweden published their findings in the February issue of the world’s most prestigious medical journal, JAMA Psychiatry. The Karolinska Institute is a top medical university that selects Nobel Prize winners in medicine. This study was conducted with support from the U.S. National Institutes of Health (NIH).

The researchers conducted a long-term follow-up of 278,027 patients aged 6 to 64 who were prescribed ADHD medications between 2007 and 2020. During the observation period, 10,388 patients developed cardiovascular diseases such as hypertension and arterial disease. The team compared these patients with 51,672 ADHD patients without cardiovascular disease.

The results showed that for every additional year of ADHD medication use, the risk of cardiovascular disease increased by 4%. The risk increased by 9% for 1 to 2 years of use, 15% for 2 to 3 years, 27% for 3 to 5 years, and 23% for more than 5 years. ADHD medications particularly raised the risk of hypertension and arterial disease. The risk of hypertension increased by 72% for 3 to 5 years of use and 80% for more than 5 years. The risk of arterial disease increased by 65% for 3 to 5 years and 49% for more than 5 years. The association between ADHD medications and cardiovascular disease was observed in both males and females across all age groups from children to adults.

Experts interpret this study as a turning point for ADHD treatment methods, shifting from pharmacological to non-pharmacological approaches. Dr. Hanwook Ryu, director of Ryu Hanwook Pediatric and Adolescent Clinic, said, "Currently, the first-line treatment for ADHD is medication. Even in mild cases, medication is the textbook treatment." He added, "This study’s results are expected to change this treatment paradigm." Dr. Ryu explained, "While the effectiveness of medication is important, so is the risk. In the future, there may be a shift toward avoiding ADHD medication treatment that carries cardiovascular risks." Non-pharmacological treatments for ADHD include methods such as applying microcurrents to the forehead to improve attention, which was approved by the U.S. FDA in 2019.

Meanwhile, in Korea, there are many concerns about the misuse of ADHD medications as so-called "study-enhancing drugs." The temporary stimulating effects of ADHD medications have been falsely promoted with claims such as "improving concentration" and "allowing study without sleep." In April last year, a group caught distributing so-called "drug drinks" to teenagers in the Daechi-dong academy district in Seoul lured them by claiming the drinks were "ADHD medications that improve memory and concentration."

Dr. Ryu stated, "This study has proven that long-term use of ADHD medications increases the likelihood of cardiovascular disease even in children and adolescents." He warned, "If people are misled by baseless rumors about academic improvement and take ADHD medications, they risk damaging their lifelong health."