By Jimmy Downs

Sunday Nov 25, 2012 (foodconsumer.org) -- J. Martinez-Raga at University of Valencia in Valencia, Spain and colleagues  most recently published  a review in CNS Drugs warning that caution needs to be exercised when ADHD drugs are prescribed to treat patients with family history of cardiovascular disease.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with which patients show persistent symptoms of inattention, hyperactivity and/or impulsivity.  Use of pharmacologics to treat ADHD has been on the rise in recent years as more people in developed countries suffer the condition, according to the reviewers.

The reviewers searched major medical databases including PubMed, EMBase and PsychINFO for relevant studies in peer-reviewed journals until July 21, 2012 to review the risk of serious cardiovascular disease, particularly the risk of corrected QT interval (QTc) prolongation and sudden cardiac death associated with use of ADHD drugs.

Overall, stimulant drugs for ADHD such as methylphenidate and amphetamine derivatives are safe and well tolerated, the authors said.  Small yet statistically significant increase in blood pressure and heart rate was found associated with use of these ADHD drugs in all age groups.

The same side effects were also observed in patients using the non-stimulant medication atomoxetine, but they are generally minor, time limited and do not signfiicantly affect patients clinically in all age groups including children, adolescents and adults. 

Drugs including guanfacine-extended release (-XR) or clonidine-XR, two α(2)-adrenergic receptor agonists, used alone or together with psychostimulants by children and adolescents with ADHD did not cause sudden or unexpected cardiac death or serious cardiovascular conditions such as significant increases in QTc.  And patients using these drugs showed small decreases in mean systolic blood pressure, diastolic blood pressure and heart rate.

Use of clonidine or guanfacine was not associated with statistically or clinically significant increases in QTc.

The reviewers said in their report that the risk of serious cardiovascular events such as increases in QTc and sudden cardiac death was not increased significantly among patients using stimulants, atomoxetine or α(2)-adrenergic agonists to treat ADHD.

Nevertheless, "great caution is advised when considering stimulant and non-stimulant medications for patients of any age with a diagnosis of ADHD and a personal or family history or other known risk factors for cardiovascular disease," the reviewers wrote.

Recently, many studies have shown that using omega-3 polyunsaturated fatty acids such as those found in fish oil can moderately help ADHD patients.  Even though they are not as effective as prescription drugs, they are safer.