Meds for ADHD, Depression Dangerous in Patients with Heart Rhythm Disorder

Nov. 26, 2013

Last week, several members of URMC’s Heart Research Follow-up team presented 12 abstracts at the American Heart Association’s Annual Scientific Sessions in Dallas, one of the biggest cardiology meetings of the year. Led by Arthur J. Moss, M.D., and Wojciech Zareba, M.D., Ph.D., the group shared research on Long QT syndrome (LQTS) – a rare, inherited disorder that makes the heart particularly susceptible to arrhythmias. URMC is a longtime leader in LQTS research and Moss has made many of the most important insights into the diagnosis, prognosis and treatment of the syndrome.

Heart beating in body.Fourth year medical student Claire Zhang found that LQTS patients treated with medications for attention deficit hyperactivity disorder (ADHD) were three times more likely to faint or go into cardiac arrest than LQTS patients not taking these mediations. ADHD medications have known stimulant side effects, but up until this point little was known about their influence on patients with LQTS. Based on the results or their study, Zhang and Moss propose that ADHD medications be prescribed for LQTS patients only when dysfunctional symptoms clearly require therapy.

In a similar study, Zhang and Moss showed that LQTS patients taking anti-depressants were also more likely to experience cardiac events. The likelihood of fainting, cardiac arrest and sudden cardiac death in patients treated with antidepressants such as selective serotonin receptor inhibitors or SSRIs was greater than 60 percent, compared to a 35 percent risk in LQTS patients not taking the medications.

Other presenters from the Heart Research Follow-up team included Jean-Philippe Couderc, who revealed a new way to instantaneously measure cardiac changes in LQTS patients.  Valentina Kutyifa and Saadia Sherazi shared research on factors that can be used to identify which patients respond best to cardiac resynchronization therapy plus defibrillator (CRT-D), a device that Moss and Zareba’s group has studied extensively. Martin H. Ruwald and Anne-Christine H. Ruwald presented studies on cardiac resynchronization therapy’s influence on reverse remodeling – the improvement in the mechanics and overall functioning of the heart.