Association between pharmacological treatment of psychiatric symptoms and cardiovascular adverse events in children and young adults

The number of young patients with medication for psychiatric disorders (psychotropic medications), especially for ADHD, has increased in Sweden over the last decade. At the same time, the incidence of cardiac events has increased in this population. Psychotropic drugs may cause various cardiac events, including sudden death.

The aim of this current project is to assess the association between use of psychotropic medication for ADHD, beyond mono-therapy, and risk of different cardiac events.

Requests for cardiac risk assessments to cardiologists along with increased cardiac events, has revealed a knowledge gap regarding safety with ADHD drugs, in combination with other medications, longtime treatments, comorbidity, in different ages, and sexes.Adverse reactions to ADHD drugs have been studied as mono-therapy in young, but other psychotropic drugs are mostly studied in adults.

Our hypothesis is that psychotropic medication may play an important role in the increased incidence of cardiac events.

This will be studied by two types of epidemiological study designs using data from national registers; 1) Prospective cohort study: Young individuals, 5-30-years, exposed to ADHD treatment will be followed prospectively until a cardiac event. 2)Case-control study: Young patients, 5-30-years, with an episode of a cardiac event and the association with ADHD treatment and polypharmacy will be assessed.The project is a joint research consortium between clinical specialist areas which enables several clinical aspects to be considered, and also that the study results are communicated to relevant health care sectors and patient groups.

By the study´s large sample size and power to detect even smaller risk estimates, this national-wide population-based study will contribute substantially to a better risk-benefit assessment, and in the long term, lead to better personalized psychopharmacological drug treatment.