Stimulant Drugs & Risk of Cardiomyopathy

Stimulant Drugs & Risk of Cardiomyopathy
Content Discussed in the Video
Article a StudyFinds.org website:
studyfinds.org/adhd-meds-hear...
Actual news release from American Academy of Cardiology:
www.eurekalert.org/news-relea...

[@tayzonday]

Everyone who invested time and resources in a longitudinal study is desperate to have it mean something significant. Nobody gets grant money, board seats, speaker honorariums, visiting professorships, paper authorships, and private sector consulting gigs by bragging “I pioneered a longitudinal study with no paradigm-shifting outcome nor actionable conclusions whatsoever!”

[@IntegrityMeansAll]

I really hope this study is invalid but imo it makes sense considering it’s a very potent stimulant that is known to cause certain effects when not medically prescribed. So why exactly would it have a different effect on the heart just because it helps people with ADHD in terms of brain function ?

[@Masamune_Xero]

Hey, it's that one guy. 😂

[@Faladaena]

@@IntegrityMeansAll I wanted to ask whether you got _'ze jab'_ but on on 2nd thought,. I better give it a miss...😑

[@InfiniteInsightAcademy]

Can we The Academy use your incredible song "Chocolate Rain" in one of our videos?

[@kenhaze5230]

A negative result is a result. It'd be a big deal if there were high confidence therapeutic use of amphetamine and derivatives had no risk of cardiomyopathy, given there is a known mechanism by which it COULD occur, and DOES occur in abuse.

[@sarahs7669]

My blood pressure has gone down since I’ve been medicated because I’m not stressed the eff out by inexplicable constant failure all the time.

[@6surfer6]

me 2 🫶

[@Magicme79]

Ritalin has made my heart much more healthy, because I was never able to maintain a good diet and exercise routine before.

[@pamelaryan8753]

I have been taking Adderall for over 25 years and my cardiologist says I have the heart of a youngin!

[@VividFlash]

Great to hear!

[@jen_counihan]

That’s great to hear! How many days a week and at what dose?

[@MissAynneK]

Adderall is helping my heart by giving me clarity and fostering the ability to not go into anxiety spirals

[@bombastixteuton1130]

Dr Barkley could you maybe do a video on Bupropion in ADHD and comorbid depression treatment? I couldn't find a video of you talking about that medication

[@jamiejohnson5748]

Adderall has helped me organize my living space enough to install a walking treadmill. Believe it or not, my blood pressure is lower after being on Adderall for 5 months. It averaged 118/81 before taking it, and now I average 114/79, and I measure an hour after taking my meds. My theory is that I have better control over my life, so my blood pressure is lower because I am less stressed out and my life is less chaotic. It doesn't "fix" everything, but it's easier to be productive. I keep calendars now, I take my vitamins, I drink more water, I'm more patient with conversations, I eat healthier. I'm even starting a better paying job next month =) It's been great.

[@topiuusi-seppa5277]

Well that reminds me of the time we collectively pooped our pantaloons for asthma medication Symbicort DOUBLING the risk of lethal asthma attack. Turns out the change was also less than 1% both with other medications and with Symbicort. If I recall correctly that increase was also compared to some other medication and it was still a big improvement from unmedicated asthma 😅 I don't understand what it is about science that's so hard to the media. I figured out that asthma medication thing myself and that was when I was junior high aged. More to the topic of the video, I've actually noticed my ADHD meds lower my blood pressure and resting heart rate. I do not doubt that Vyvanse technically does increase blood pressure and pulse, but my personal experience is that stress increases them so much more and adhd meds reduce the causes of stress so much that for me it's a net negative change 😆

[@rafa10perez]

This BS media headlines are tiresome and misleading people... Agreed professor

[@kellyd2691]

I watched one of your seminars from years ago and you basically described me in each chapter to a T. At 52 and waiting for a diagnosis I'm blown away at how I've missed this. My life has almost been a train wreck, never able to achieve anything, and no one being able to understand it considering I am not a stupid person. Unable to motivate myself, planning and writing lists I never looked at again. I'm in a mediocre Govt job, never married, no kids, limited friends, problems with alcohol and overweight for the last 10 years. Never understanding why I could not accomplish anything. Back when I was 20 a psycholigist semi diagnosed me with ADD but my reaction to Dexamphetimine, according to him, meant I didnt have it. Its a long time ago and diagnosis has improved. Having most of the symptoms, and no other answers as to why I'm so hopeless. I hope a diagnosis now will help me to get to a point of enjoying at least the later part of my life 🤞 Thanks for your work.

[@go-farm]

The closed captions that played before I clicked on the vid said Dr Russ SPARKLY ✨️ 😅 Totally befitting ❤

[@joelwilliams3115]

My psychiatrist seems to think my heart will break down in 20 years from stimulant usage so she won’t prescribe dexamphetamine top ups on top of my Vyvanse. She used to say ‘don’t worry about your heart’ but now she’s giving me more heart anxiety

[@francisturney2938]

Interesting, but as you say clinically insignificant, for now. The question for me is of the potential increase in patients with other risk factors. What if you drink a lot? What if you smoke ciggarettes or chew nicotine gum? What if you eat poorly and don't excercise? The reason heart disease is the number one killer of American's is not because any single factor is going to vastly increase your chances of heart attack (outside of maybe heavy drug use or smoking), it's because of many smaller factors, ubiquitous in the general population, that add up over a lifetime. Another thing to take into account is 20-40 year old are typically not the population at risk for heart disease, it's the 50+ year old who have the highest risk, because the lifetime of plauque buildup and cariovasular weakening. The implication is not that you shouldn't take ADHD medication, the implication is that stimulants, and potentially any artifical vaso-constriction will add to your risk for heart disease, and that ADHDers should be taking extra care to manage their heart health by eating well, excerisisng, and not smoking. I also disagree with the assesment that half a percent is a small number, that's roughly the rate that people die from COVID or the flu, and those things were considered epidemics under those metrics.

[@hanafudafilmssamios-dixon7813]

Then surely our science must be even more scholarly rigourous and well-designed because we’re looking at the models of comorbidity and how they exacerbate through interaction as co morbid. I think it would be hard to find evidence that having free mood disorders as well as ADHD that perhaps there is an interaction that has a positive outcome. I don’t agree because we know very well about the burden of disease and the more you have the more burden doesn’t get any easier. It just means there’s more work for the person to do and more work for the clinician to do…. But you’ll find your answers here in what you’re asking amongst the epidemiological studies because that’s what they do. They conduct huge studies that deploy very long very rigourous collections of metrics and psychometrics that are arranged so that there is no context bias or it’s minimised that has construct validity and criterion related validity meaning they are useful . I would like to know from the study if it was to be more scholarly rigourous and be valuable to the researcher, the clinician, the Pubic Health Officers, and ultimately wellness in the patient, is if there is some statistically significant yes but sizable difference in group means or regression factors, is there a factor of abusing your stimulant medication. This as well as some of these other comorbidities which would be ruled in or ruled out of factors that account for greater impairment including e.g. insufflating or shelving, their Ritalin, plus a half a bottle of scotch to take the edge of this kind of confounding behavior that requires a different approach to treatment. It becomes a harm reduction issue as well as reducing what they’ve learnt from abusing that medication to getting into the routine of using the medication that will make their lives so much more healthier…. I think you’ve got a good point. You think at the cutting edge is what I’m saying and this is a paper that has Clickbait for a title. I’m an old person. I only learnt what that meant a few years ago but it’s a a word to describe impulsive reactions to inflammatory like statements that lead you to poor information. And I apologise if I pontificated too much or laboured my point. Dr. J.Dixon

[@hanafudafilmssamios-dixon7813]

Workshop presentation with no peer review or scholarly rigorous research process. Workshop often use “sexy” titles to draw bums on seats for the workshop…

[@ss-hb7im]

Thank you Dr B. As prescribers these articles also scare us. Made me think about whether I’m doing the right thing. But you’ve put this concern into perspective. Much gratitude. 🙏🏻

[@ADHDMoney]

Thank you, as always, for breaking these down for us.

[@Faladaena]

Thanks for sharing, doc (much appreciated as always)!

[@leilap2495]

I’m more concerned about going undiagnosed and untreated like my dad did 😬 Because I saw what happened to his heart because of his inattention and hyperactivity! It’s amazing we are both alive, as we were in very serious accidents in our youth, among other events that were related to inattention and impulsivity. I survived to late diagnosis, and I will continue to take my medication to promote a healthier longer life. I was screened with an EKG before starting my medication.

[@stoneneils]

I quit driving cuz was undiagnosed and uh....i had more accidents that i did successful drives lol..not quit but oh boy i was an aggressive impatient little teenage driver to say the least. I am also lucky to be alive, I'd floor it at 4am. As did my cousin but on a motorcycle, RIP.

[@verymuchgerman]

Thank you

[@PVVI2015]

Thank you🤗

[@Maryam-111]

Thank you 🙏 ❤❤❤❤🙏🙏🙏🙏🙏

[@katsweeterly2039]

ahahhaahhha „let’s reach for the pepsin!“ - I almost snorted my Pesi zero out of my nose ;) and calmly will proceed to taking my meds as usual.

[@LordPinky455]

That Pepsi Zero is slowly killing you more than the meds 🤐🙃

[@runicrow7289]

When I was prescribed Adderall as a teen, it caused my heart rate to sit between 120 and 140 when I was as calm as I could be. When it was brought to my attention that it was bad, I started taking extra care to monitor my heart rate, and it went as high as 255 on a mountain bike ride. I stopped taking it, and it started falling on average over time. I still get chest pain regularly.

[@MartynaRowniak]

My fav paper towel guy ❤

[@OldManSparkplug]

Publish or Perish means publishing garbage :( Thank you Dr Barkley.

[@hanafudafilmssamios-dixon7813]

Oh it sounded like a cox survival multiple regression analysis approach! Mmm correlation. When the sample size is too large there is a tendency to always reject the null hypothesis therefore a type I error is inevitable. Overpowered designs and big data without the appropriate statistical analysis are poor exploratory studies. Large sample sizes are best handled with SEQ modelling methods. If this was an epidemiological study then logistic regression with the appropriate post hoc analysis should show incidence and prevalence, if the data set is handled appropriately. It certainly is an eye catching title, but I believe we need research that extends the scope of current clinical knowledge. The good news is that ‘bad’ research should be published! It guides future clinical researchers away from making the same mistakes or conducting redundant research (a waste of grant money). Anyway thank Dr. Barkley! Dr. Jason Dixon (Brisbane)

[@chesneymigl4538]

Oh no, say it isn't so! You mean P values actually doing their job and rejecting the alternate hypothesis? (buckets of sarcasm) This is a huge problem all over science right now. Because only exciting research gets rewarded, studies get skewed badly. That's not even mentioning how little people want to fund replication studies.

[@hanafudafilmssamios-dixon7813]

@@chesneymigl4538indeed especially the sciences of the mind… the clinical world has fallen because about 20 years ago, we turned universities into businesses and no longer taught the philosophy of science. This sounds like an easy; well put them back, but we have a couple of generations who can’t formulate a research question what solves the problem “So what?” or why is this important to engage this question scholastically ? My colleagues who went tribal with the CBTs kept asking for grants and kept perpetuating redundant research. All to for more evident that “it works” but psychological therapy only accounts for about 15-18% of the clinical outcome…. So after forty years of farting around we discover that the therapist client relationship accounts for a whopping 30% of the clinical outcome among the modifiable factors! In the end Carl Rogers had it right and we overlooked his work until the push against the strife that science that seeks Dodo birds (your p values are one of them). Don’t necessarily make psych/ counseling more “scientific “ . Why don’t we know this? Because we don’t teach the philosophy of science more.. Great works like the limits of science and the science of limits. Any of Karl Poppers works definitely..Ayan Rand objectivism. There is also the historiography behind the philosophy of science so if we follow what happened before amongst those who aimed high in the Academy, we discover how to avoid the mistakes that we’re making today. In my younger days I presented at conferences but I was passionate about the subject that I was presenting and also the research and evidence that I use because ultimately what I was going to provide at my international workshop to other practitioners was a method to relieve human suffering and the human condition ! That’s pretty important when you think okay if you’re a tribal elder what do you do? You make your CBT psychological therapy into an app and get another grant to see if there’s evidence that it works. What have you done? You’ve taken out the number one statistical factor modifiable factor that accounts for clinical outcome in that special relationship, between therapist and patient. There was a group of us some years ago who came together as scientist against the redundancy of research and psychology and counselling a new scientific manifesto. It was to be presented by Scott Miller at the evolution of psychotherapy which is the capstone professional workshop run by the Erickson Foundation. But we couldn’t get anybody to back the idea even with Miller Duncan and Hubke at the helm giving that key note speech. So Scott went off to Scandinavia because his bilingual and he found emerging professions of psychology and counselling and he made sure they were guided away from the mistakes of the west. I did the same in Vietnam over three years. . My Vietnamese students who are now deans of colleges some work for the WHO , too far greater quality of research that I’ve ever done and have excelled most of my peers except maybe a couple of very brilliant almost polymath professors. So I hear your sarcasm in cynicism and it warms my heart for what else do we have when clinical psychology ignores the undeniable power of social connectedness? I worked in epidemiology for three years and we always measured social connectedness because it’s been measured since the year.the scales have criterion related validity. And it factor if we use say structural equation modelling that describes why people become well quicker or have less severe symptomology if they maintain their social connectedness which of course they don’t so what do we do? We lock them up we bring them out and we put them in a room with one other person later on we might put them in a group where it should be the other way around. We should be taking them by the hand outside the clinical Rooms and setting and delivering the therapeutic alliance in an environment that is real natural and the very cause of reactionary mood disorders or exogenous mood disorders. I see this article as cheap research I look through it. There’s no indication of where the data have. The data was handled. There’s no indication of the quality of the evidence that or any kind of rubric or criteria that sets the good science apart from the bad science we all think now that’s just good science that’s published and at one stage it was and that is wrong. We should publish both good and bad science but now we just leave because no one teaches the philosophy science anymore, that , science infallible. Yeah among these types of let’s get bums on seats because big conferences are boring and if you’re part of the academy you don’t really go to workshops but something like this my drag one I don’t know Russell Barkley I think it’s Clickbait. It will never get published in a review journal. There’s no way it’s poor. It’s too poorly written. And so it will remain in print at whatever conference. This is if they produce and unreviewed publication of all the papers that were presented at the conference like the American educational research association except in that case it’s really hard to get a spot to present your work unless it is very good, it’s like the lancet of all things educational including clinical education. And indeed what is what I call the uzanne abusive statistics is when you present such little changes between correlations or group comparisons. And this is where your savvy mind my friend comes to play people believe in the P value like it is some kind of central statistical Foundational approach to psychological therapy, whereas it’s just to rule out one of the mistakes that researchers make when they are not blind to what they are studying. That is why I think we have the ability to use amazing software packages like Amos which is a structural equation modelling program where you can run things like confirmatory factor analysis which gives you a amazingly powerful statistical tool to test grounded theory, to construct and begin to work towards gathering the evidence that psychometrics relies on and that is to have a metric that is predictive. it’s very hard to get there and it’s extremely difficult undertaking and scales that are may never come any further than content or face validity. So I’ll stop there because I found myself pontificating to somebody who is probably in the choir and indeed your attitude and thoughts towards the matter resonate with me indeed.. thank you for your comment, let’s live life without shit science… Resisting to go on because I just remembered you should hear my critique of big data but that so for another day maybe not not for this thread of conversation which is poor research presented out a conference that will scare some people and if one person is scared for no reason then our science is maleficent. So that serious stuff we’re dealing with peoples suffering and their capacity to transcend the human condition when it confronts us . This should be the passion of every clinician and it would be if we taught the philosophy of science, especially the philosophy behind legal and ethical practice.. and that’s for further reading. I apologise for my geek and my passion for scholar. Excellence will die with me. Dr. Jason Dixon

[@Amyearby]

I would love to see you talk about cold baths and showers affects on ADHD

[@IntegrityMeansAll]

That should not be considered news imo (hasn’t that been reported since decades?) but unfortunately people with ADHD do need them to function.

[@BodilWandt]

One thing tjat I wonder if have been studied is how to deal with two meds that separatly can be a risk for the heart if over dosed. Like Elvanse and thyroid hormones. When two different doctors administrate the meds, there has to be risk for complications.

[@adamloepker8057]

Still interesting. I cant help but feel like this could be diet related since stimulants tend to discourage hunger. Quality diet is already difficult to attain these days. Regardless, people would probably still do better to do their best to keep up with good diet, regular exercise, and quality sleep while on these medications.

[@Masamune_Xero]

My med provider makes me get a damn EKG every year. And wants blood tests. She's paranoid as fuck. I've never had a heart-related issue ever. I've been taking Dexedrine aka dextroamphetamine on and off since I was 8 and totaling at least 11 years. I took 60mg per day for about 5 of those years.

[@chesneymigl4538]

I am no longer able to donate blood because every time I am "tachycardic". Yeah, of course! It's my normal and only partly because of meds. I'd rather risk fainting, and saving some lives than staying upright and knowing people are dying from lack of blood products. Why won't they let us sign a waver or something? The last time, I actually wasn't tachy because I skipped my meds and went early. Then the excuse was low iron... by a tenth of point. WTF!

[@Masamune_Xero]

@@chesneymigl4538 Oh yeah, I used to donate plasma for a little extra money, but got sent away more than half the time for being ever so slightly over the pulse limit. Like, okay, have people die then, whatever. Very stupid.

[@maxkopfraum]

My doc is worried about Long QT / Arrhythmia with my stimulant medication and wants to see an EKG every few months.

[@omalou42]

Just fear mongering and playing on the ignorance of the public.

[@5fingerjack]

Very interested in this. My cardiologist dx me w/ microvascular disease caused by long term use of lisdex/vyv. I have had afib(version), now have had tachycardia. Low bp, low ldl/high hdl. Clear angio. Im not sure if contuing my prescription is ok, but i struggle w/o it.

[@chesneymigl4538]

Balancing brain vs. body is just part of living for a lot of us. I hate it, but I tell my doctor I'd rather risk the health issues because what's the point of living if I can't function. -_-

[@KylePandapatan]

@@chesneymigl4538 Plus w/o the meds, one is more susceptible to self-medicating w/ sugar, caffeine, alcohol, or anything potentially more harmful (like risky sports to get the thrill of dopamine). Heck without the meds, it’s so easy to get delayed sleep phase. Hyperfocus on a job in the middle of the night…and end up not sleeping. Much worse for the heart.

[@taysan98]

I worry about this bc I found out I have Atrial fibrillation as a 25yr old and I’m on stim meds so the risk kinda pops in my head every now and again

[@ChrisWaterguy]

Small nitpick, 0.2% is 1 in 500 additional cases, not one in 2000. Still very small.

[@stoneneils]

I wonder how many people would notice the meaning if a gym were named CardioMyOpathy.

[@dove9527]

Can you please help me with something? It's a big ask but please I'm helpless. My father doesn't understand what ADHD is. He found videos online that ADHD is not real. I'm capable. I'm smart. Until 12 I had aced all the tests in school. I'm in a rut now. My father thinks stimulant medications have side effects. I want to go abroad, use medication and study. Can you please make a video explaining why medication is important and how ADHD symptoms affect someone's life? Please Dr Russell.

[@piedpiper1172]

He has. You can also find his older “30 things parents of adhd children should know.” I haven’t watched it yet, but the thumbnail of his Peterson response video suggests he addresses it there as well. You can also show people his google scholar page. Dr Barkley’s h-index is staggeringly high.

[@pattyw9543]

Haha brawny guy 😂

[@nedahashemian3973]

not everyone lives in America

[@alexdrockhound9497]

actually, the earths entire population is in the Americas. Nobody lives in europe asia or africa, and australia isnt a real place.

[@nedahashemian3973]

🤣🤣🤣🤣🤣😆😆😆😆

[@nedahashemian3973]

not entire population, the important population

[@hanafudafilmssamios-dixon7813]

Perhaps the patient population for those that can be treated in America, and for those that cannot banished to the outer parts of the Earth to suffer like leopards in Australia and Asia… it’s probably most dystopian and depressing sort of the future world I’ve heard in a long time. Well done.

[@alfdiinternet2486]

Be patient my fella maybe this is journey😂 I am from asia and adhd make me struglle with this problem

[@nedahashemian3973]

risk is not far, some producers might not have some standards, I took Ritalin once and my heart beats raised

[@alexdrockhound9497]

when i take it i get sleepy and have a hard time staying awake.

[@ArabicOogway]

Ritalin is doing miracles for me

[@ArabicOogway]

ایرانی هستید؟

[@nedahashemian3973]

بله ایرانی ام:)

[@nedahashemian3973]

بله برای بعضی ها خیلی خوب جواب می ده، اما من ویاس می خورم و خیلی بیشتر جواب می ده، Ritalin does well for many, but I take Vyas instead and it really works

[@GaryandTerrysgravystain]

Hi Russ thank you for all your information that you have provided. Question… what are your thoughts on a genetic micro deletion and adhd? Micro deletion is when a piece a chromosome is missing or even the whole chromosome.. thanks

[@russellbarkleyphd2023]

my limited understanding of the complex field of micro genetics is that ADHD involves more single nucleotide substitutions, along with gene copy number variants (such as 7+ repeats of the DrD4 or DAT1 genes as examples) and other rare gene variants rather than deletions. there is also a little evidence that the telomeres at the ends of some chromosomes show premature aging and decay but not much has been said on that in the last few years. thanks for watching.

[@kukoistava.]

Love your point about correlation vs causation. I'd love to see further study here which actually considers the metabolic role of catecholamines, and looks at those diagnosed with both ADHD and metabolic / cardiovascular syndromes. Maybe someday we can move far, far away from viewing dopamine as just the "pleasure / reward" neurotransmitter and actually consider a holistic view of its role in multiple systems. A girl can dream :)

[@hanafudafilmssamios-dixon7813]

Dream dream and do that even more. Because if you wanna be the best at your craft then that’s the kind of goal you need to aim for in your Scholastic endeavours and before departing on that journey a good dose of understanding the philosophy of science may assist in choosing research questions that are meaningless, they might be grammatically meaningful but they don’t mean anything to relieving human suffering in the patient.