The NHS is failing to offer ADHD patients heart checks before they begin medication – putting them at risk of death, a leading charity has warned.
Attention deficit hyperactivity disorder (ADHD) is usually treated with stimulant tablets that speed up heart rate and increase blood pressure.
A record number of Britons are now taking the daily pills, which were once offered only to a small number of children but are increasingly being given to adults.
The number of women on ADHD medication has risen 20-fold in the past 15 years, while the number of men has risen 15-fold.
However, many patients starting on ADHD medication may have undiagnosed heart defects – which affect around one in 300 people – according to the charity Cardiac Risk In The Young.
The warning comes less than a year after an inquest concluded that a 28-year-old City finance worker’s death was linked to his stimulant ADHD medication.
Jacob Wooderson, from London, suffered sudden arrhythmic death syndrome – when a young and seemingly healthy person dies of cardiac arrest – shortly after his dose of Elvanse, also known as lisdexamfetamine, was increased.
Elvanse was listed as a cause of his death. He had been diagnosed with ADHD six months earlier.
At the time, coroner Sarah Bourke called on the Government to launch an inquiry into the tablet’s safety, which is ‘increasingly being prescribed in the NHS’. However, no such inquiry was ever commenced.
Jacob Wooderson, from London, suffered sudden arrhythmic death syndrome shortly after his dose of Elvanse, also known as lisdexamfetamine, was increased
Moreover, there are currently no requirements for NHS doctors to screen ADHD patients for heart issues before prescribing them the daily tablets.
Dr Steven Cox, chief executive of Cardiac Risk In The Young, says that all ADHD patients should be offered an electrocardiogram (ECG) – a test that records the electrical activity of the heart – before any medication is administered.
‘The vast majority of people with heart defects do not know they have one until something goes wrong,’ says Dr Cox.
He explains that ADHD medication can impact the heart and put those with underlying issues at risk. However, as prescriptions for ADHD drugs rise, a higher population is being exposed to their dangers.
‘Offering all patients an ECG before they begin treatment is a sensible and easily achievable policy,’ he adds.
Attention deficit hyperactivity disorder, or ADHD, is characterised by an inability to concentrate or stay still for extended periods.
Previously it was considered a rare condition that affected children – primarily boys. However there are now 750,000 children and 1.5 million adults diagnosed with ADHD in the UK.
There are a record number of patients taking ADHD medicines, according to Oxford University research published in January.
Elvanse was listed as a cause of Jacob Wooderson’s death. He had been diagnosed with ADHD six months earlier
The most widely prescribed medication is methylphenidate – sold under brand names including Ritalin, Concerta, Delmosart, Equasym and Medikinet. The tablet is a stimulant, meaning it can improve focus and attention.
Prescriptions for the tablet have risen across all age groups, including in older adults and children as young as three. But in recent years various studies have called into question the safety of these medicines.
Experts say in rare occasions the tablets could trigger psychosis.
‘I have now seen two patients who suffered serious psychotic episodes after taking ADHD medication,’ says Professor Joanna Moncrieff, a psychiatrist at University College London.
One 2018 US study found that people on the drugs were four times more likely to get the degenerative brain disease Parkinson’s as healthy people – and twice as likely as ADHD patients not taking medication.
Experts say the link between ADHD medicines and heart problems occurs because the drugs increase heart rate and blood pressure.
NHS guidance states patients need to have their medical history checked as well as their heart rate and blood pressure.
But there is no requirement for an ECG test to look for any defects – unless there is family history of these issues or existing underlying heart problems.
A spokesman for the National Institute for Health and Care Excellence (NICE), the Government body that decides NHS guidelines, told The Mail on Sunday that while all ADHD patients must undergo a cardiovascular assessment, an ECG is not needed.
