A small pill, commonly prescribed to both adults and children, may be a double-edged sword when it comes to heart disease prevention and treatment. Dr. Evan Levine, a seasoned cardiologist based in Scarsdale, New York, as well as a popular figure on TikTok, is raising serious concerns about the potential cardiac risks associated with medications often prescribed to improve the academic and athletic performance of children.

In a recent conversation with The Post, Dr. Levine expressed his strong disapproval of what he refers to as the borderline child abuse of prescribing stimulant medications for ADHD. These drugs, he explains, are categorized into two main classes: the methylphenidates, which include well-known medications like Ritalin and Concerta, and the amphetamines, which encompass Adderall and Vyvanse. Both categories function by increasing norepinephrine levels in the bloodstream, which can lead to elevated blood pressure and a heightened risk of arrhythmias, commonly classified as irregular heartbeats.

While such effects might seem minimal at first glance, Dr. Levine urges caution, citing new research that amplifies his worries about long-term implications. He critiques the U.S. Food and Drug Administration (FDA) for downplaying the potential risks associated with these stimulant medications. In 2011, the FDA based its safety assessment on a study that concluded there was no significant increase in cardiovascular events among young and middle-aged adults, Levine explained. However, this study only had an average follow-up period of 1.3 years, which is woefully inadequate for understanding long-term effects.

Dr. Levine raises a crucial point regarding the long-term use of ADHD medications in children. What happens if a child is on these medications for 20 years? The FDA has not provided any commentary on this issue. Likewise, what about elderly patients or those with pre-existing heart conditions, such as congenital heart defects which affect 1.5% of the population and heighten the risk of serious complications like aortic aneurysms? The FDA has failed to fully address these concerns, he stated emphatically.

Furthermore, emerging studies are beginning to corroborate Dr. Levine's warnings. A recent study scheduled for publication in April 2024 indicates a staggering 57% increased risk of heart disease among young, healthy adults aged 20 to 40 who have taken these medications compared to their peers who have not. Alarmingly, the same study found that 1 in 500 of these patients were diagnosed with cardiomyopathy, a serious condition that affects the heart muscle.

Dr. Levine's insights extend beyond just the pediatric population. He highlights the growing number of adults diagnosed with ADHD, which has reached a staggering 1 in 17. However, he raises questions about the legitimacy of these diagnoses, noting that many individuals are taking these stimulants without a formal ADHD diagnosis solely to enhance their focus during exams or to boost their athletic performance.

Moreover, the rise of telehealth services has further complicated the prescribing landscape. Dr. Levine warns that the ease with which individuals can obtain these medications online often with little to no vetting is reminiscent of a local drug dealer meets telemedicine. He stresses the urgent need for more comprehensive mental health care solutions, including accessible psychiatric evaluations and alternative non-stimulant therapies.

Interestingly, these stimulant medications are not universally accepted across all fields. In Olympic sports, for instance, athletes must apply for an exemption and provide proof of an ADHD diagnosis to avoid disqualification. Dr. Levine speculates that some individuals may feign a diagnosis to gain an unfair advantage in competition.

The takeaway from Dr. Levine's cautions is clear: while ADHD is a legitimate condition that warrants treatment, it is imperative that such treatment be approached with heightened caution, increased oversight, and a critical mindset regarding the over-reliance on pharmaceutical solutions.