Prompted by reports of suicidal behaviour in patients taking ADHD medications, Health Canada is issuing “stronger, clearer warnings” about the risks associated with the drugs.
The new warnings advise that there have been reports of suicide-related events in patients treated with ADHD drugs. The reports involved thoughts of suicide, suicide attempts, and in a very small number of cases, completed suicides. These events have been reported at various times during treatment, particularly at the start or during dose changes, and also after stopping the drug treatment.
This risk is already known for one ADHD drug, Strattera (atomoxetine) and was incorporated into its prescribing information and communicated in 2005. New information has emerged since to suggest that the risk of suicidal thoughts and behaviours may apply to all other ADHD drugs. There is little evidence to establish that these drugs cause suicidal thoughts and behaviours, but it is possible that they may contribute to the risk.
ADHD drugs are available by prescription only and are authorized for use in adults and children over the age of six years. There are several brand name and generic drugs available in Canada:
ADDERALL XR (mixed salts amphetamine extended-release)
BIPHENTIN (methylphenidate controlled release)
CONCERTA (methylphenidate extended release)
DEXEDRINE (dextroamphetamine sulfate)
INTUNIV XR (guanfacine extended release)
RITALIN SR (methylphenidate extended release)
VYVANSE (lisdexamfetamine dimesylate)
“It is Health Canada’s view that the benefits of these drugs in the effective management of ADHD continue to outweigh their risks,” said Health Canada in a statement. “The possible occurrence of psychiatric side effects with ADHD drugs is included in the prescribing information (product monographs) in a warning section that emphasizes the importance of monitoring moods, behaviours, thoughts and feelings in adults and children taking these medications, and the importance of taking psychiatric disorders into account when prescribing these drugs.”