Global burden of ADHD medication-associated cardiovascular disease, 1967–2023: A comparative analysis using the WHO pharmacovigilance database

IF 3.8 4区 医学 Q1 PSYCHIATRY Asian journal of psychiatry Pub Date : 2024-08-30 DOI:10.1016/j.ajp.2024.104209
{"title":"Global burden of ADHD medication-associated cardiovascular disease, 1967–2023: A comparative analysis using the WHO pharmacovigilance database","authors":"","doi":"10.1016/j.ajp.2024.104209","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Despite the widespread use of attention-deficit hyperactivity disorder (ADHD) medications and their known sympathomimetic effects on the cardiovascular system, cardiovascular risk assessment of these medications using comprehensive global data is limited. This study investigated the association between individual ADHD medications and cardiovascular disease (CVD) using global pharmacovigilance data.</p></div><div><h3>Methods</h3><p>Reports from the World Health Organization international pharmacovigilance database were utilized (1967–2023; total reports, n=131,255,418). Reporting odds ratios (ROR), and information components (IC) were calculated to evaluate the association between each medication and specific CVDs.</p></div><div><h3>Results</h3><p>We identified 13,344 CVD cases related to ADHD medications out of 146,489 cases of all reports on ADHD medications. Cumulative reports on ADHD medications have shown a steady increase, notably in adults since 2010. ADHD medications were associated with a higher risk of CVD overall (ROR [95 % CI], 1.60 [1.58–1.63]; IC [IC<sub>0.25</sub>], 0.63 [0.60]), with a higher association observed in females than in males. Among specific CVDs, all drugs were associated with an increased risk of torsade de pointes/QT prolongation, cardiomyopathy, and myocardial infarction. Conversely, heart failure, stroke, and cardiac death/shock were exclusively associated with amphetamines. Lisdexamfetamine showed a weaker association with all CVDs compared to amphetamines, and methylphenidate exhibited the lowest overall association with CVD. Atomoxetine had the second-highest association with torsade de pointes/QT prolongation.</p></div><div><h3>Conclusions</h3><p>The associations between CVDs and ADHD medications vary, with amphetamines posing a higher risk, while lisdexamfetamine and methylphenidate exhibit better safety profiles.</p></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian journal of psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876201824003022","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Despite the widespread use of attention-deficit hyperactivity disorder (ADHD) medications and their known sympathomimetic effects on the cardiovascular system, cardiovascular risk assessment of these medications using comprehensive global data is limited. This study investigated the association between individual ADHD medications and cardiovascular disease (CVD) using global pharmacovigilance data.

Methods

Reports from the World Health Organization international pharmacovigilance database were utilized (1967–2023; total reports, n=131,255,418). Reporting odds ratios (ROR), and information components (IC) were calculated to evaluate the association between each medication and specific CVDs.

Results

We identified 13,344 CVD cases related to ADHD medications out of 146,489 cases of all reports on ADHD medications. Cumulative reports on ADHD medications have shown a steady increase, notably in adults since 2010. ADHD medications were associated with a higher risk of CVD overall (ROR [95 % CI], 1.60 [1.58–1.63]; IC [IC0.25], 0.63 [0.60]), with a higher association observed in females than in males. Among specific CVDs, all drugs were associated with an increased risk of torsade de pointes/QT prolongation, cardiomyopathy, and myocardial infarction. Conversely, heart failure, stroke, and cardiac death/shock were exclusively associated with amphetamines. Lisdexamfetamine showed a weaker association with all CVDs compared to amphetamines, and methylphenidate exhibited the lowest overall association with CVD. Atomoxetine had the second-highest association with torsade de pointes/QT prolongation.

Conclusions

The associations between CVDs and ADHD medications vary, with amphetamines posing a higher risk, while lisdexamfetamine and methylphenidate exhibit better safety profiles.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
1967-2023年ADHD药物相关心血管疾病的全球负担:利用世界卫生组织药物警戒数据库进行比较分析。
背景:尽管注意力缺陷多动障碍(ADHD)药物被广泛使用,而且其对心血管系统的拟交感作用也已为人所知,但利用全面的全球数据对这些药物进行心血管风险评估却很有限。本研究利用全球药物警戒数据调查了个别ADHD药物与心血管疾病(CVD)之间的关联:方法:采用世界卫生组织国际药物警戒数据库中的报告(1967-2023 年;报告总数,n=131,255,418)。计算报告几率比(ROR)和信息成分(IC),以评估每种药物与特定心血管疾病之间的关联:结果:在所有关于ADHD药物的146,489例报告中,我们发现了13,344例心血管疾病与ADHD药物有关。自2010年以来,有关ADHD药物的累计报告呈稳步增长趋势,尤其是在成人中。总体而言,ADHD 药物与较高的心血管疾病风险相关(ROR [95 % CI],1.60 [1.58-1.63];IC [IC0.25],0.63 [0.60]),女性的相关性高于男性。在特定的心血管疾病中,所有药物都会增加心肌梗塞/QT延长、心肌病和心肌梗死的风险。相反,心力衰竭、中风和心源性死亡/休克只与苯丙胺类药物有关。与苯丙胺类药物相比,利眠宁与所有心血管疾病的相关性较弱,而哌醋甲酯与心血管疾病的总体相关性最低。阿托莫西汀与心肌梗死/QT延长的相关性位居第二:结论:心血管疾病与多动症药物之间的关联各不相同,苯丙胺类药物的风险较高,而立思辰和哌醋甲酯的安全性较好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Asian journal of psychiatry
Asian journal of psychiatry Medicine-Psychiatry and Mental Health
CiteScore
12.70
自引率
5.30%
发文量
297
审稿时长
35 days
期刊介绍: The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.
期刊最新文献
Modulating neuroplasticity through synergistic ketamine and accelerated sequential theta burst stimulation (TBS) for treatment-resistant depression (TRD) – A case report Editorial Board Closure risk of general hospital psychiatric units: Impact of financial pressures and psychiatrist staffing challenges Effectiveness of a package of community-based mental healthcare services to address perinatal mental disorders in Bangladesh: A cluster-randomized controlled trial Human-fecal microbiota transplantation in relation to gut microbiome signatures in animal models for schizophrenia: A scoping review
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1