EXCLUSIVE: Warning over ADHD medication after man, 28, died of sudden heart failure within days of increasing dose

A CORONER is warning about the risks of amphetamine-based ADHD medication after a 28-year-old man died from sudden heart failure within days of increasing his dose.

Jacob Wooderson, 28, (above) died just 17 days after the dosage increase and within six months of getting a private ADHD diagnosis in February 2024 after he was prescribed the drug at a dose of 30mg.

His dose of "Elvanse" was increased twice before his sudden death, with no advice given about possible side effects or what to do in the event of an adverse reaction, an inquest heard.

It concluded that the cause of death was Sudden arrhythmic death syndrome contributed to by Elvanse treatment for ADHD.

Sarah Bourke, HM Assistant Coroner for Inner North London said she fears there could be more deaths due to increasing ADHD diagnoses and the use of the drugs.

In a narrative conclusion to the inquest heard in May, she said that "the dosage was increased to 50mg in June 2024 after an ECG, blood pressure, heart rate and other investigations were undertaken in accordance with national guidelines.

"In August 2024, Jacob increased his Elvanse dosage to 70mg. The blood pressure and heart rate information considered by his psychiatrist prior to prescribing 70mg Elvanse was previously submitted in June 2024 when Jacob was taking a 30 mg dosage."

Following the increase to 70mg, Jacob reported problems with poor sleep and exhaustion to his friends, the inquest heard.

Originally from Hereford, Jacob was living in north London and working as an analyst at blockchain platform Cardano at the time of his death.

He collapsed and died at his home on August 23 2024 just 17 days after the dose was increased on August 6.

A tribute page to him on Muchloved.com described him as "Beloved son of Roland and Marnie, loving brother of Joshua, partner to Noemie and friend to many."

It said he "embraced life fully and unapologetically."

The tribute added: "To many of us, he was everything. He had this wonderful, goofy side, never afraid to be himself or to make those around him laugh. Whether he was cracking jokes or simply being his warm, caring self, Jacob made everyone feel special and seen."

The keen musician would also "dance and sing at the top of his lungs walking down the street" and "just loved being the life of the party and turning every moment into something unforgettable," it added.

A fundraiser on the site has raised more than £6,700 for St Michael's Hospice and Cardiac Risk in the Young.

Following the inquest, Ms Bourke has written a Prevention of Future Deaths report, which has just been published.

She wrote in it: "The arrhythmia may have had a genetic cause or be linked to Jacob’s medication. It is not possible to establish the precise cause of the arrhythmia on the balance of probabilities from the evidence before me.

"Jacob was not given any clear written advice from his psychiatrist regarding the side effects of Elvanse or the steps to be taken if any adverse side effects presented.

"This was a missed opportunity for Jacob to have information which may have led him to seek medical advice which could in turn have led to a different outcome.'

Jacob sought the diagnosis and treatment due to long standing issues around memory, concentration and focus.

Toxicology evidence heard at the inquest established that Elvanse is a stimulant drug and that its use at any dose may result in cardiac effects including tachycardia, arrhythmias and potentially myocardial infarction. Increased heart rate and insomnia are consistent with the effects of amphetamine use even when taken therapeutically.

National Institute for Health and Care Excellence (NICE) guidance on the treatment and management of ADHD states where patients are prescribed medication for ADHD, prescribers should monitor heart rate and blood pressure and compare with the normal range for age before and after each dose change, and every six months.

Ms Bourke wrote: 'The toxicologist’s view was Jacob had video consultations with his psychiatrist. The psychiatrist’s usual practice was to make handwritten notes during a consultation... Jacob’s psychiatrist did not clearly document Jacob’s baseline blood pressure and heart rate prior to starting Elvanse or after increasing the dosage to 50 mg.

"Similarly, the advice given to Jacob regarding adverse side effects of Elvanse was not recorded at any point. It also appears that Jacob was not sent any follow up letter after his Elvanse dosage increased to 70 mg.

"Following that increase, he disclosed to his partner and friends that the 70 mg dosage of Elvanse made him 'feel weird', caused insomnia and led him to feel exhausted.

"The psychiatrist said that if they had known of Jacob’s symptoms on increasing the dosage to 70 mg, they would have advised him to stop taking Elvanse and reviewed his medication."

A study in Australia which looked at a period from 2000 to 2004 identified 64 deaths in which ADHD medications were implicated, with the average age at death of 38.2 years.

ADHD diagnoses were documented for 37 of the people, other mental health problems for 44 people, and 51 of the deaths were deemed unintentional.

But, a separate study published in Sweden in March 2024 concluded that people with ADHD, who did not take medication, were at risk from premature deaths due to accident or overdose.

Researchers identified nearly 150,000 Swedish residents between the ages of 6 and 64 who were diagnosed with ADHD sometime between 2007 and 2018 and tracked deaths that occurred within two years of diagnosis.

They found that there were 48 deaths for every 10,000 people with ADHD who did not receive medication compared with 39 deaths for every 10,000 people who did receive medication – a 19 percent decrease in two-year mortality risk.

Yet, Ms Bourke warned: "Elvanse is an amphetamine-based medication which can have fatal cardiac side effects. It is increasingly being prescribed in the NHS and in the private sector for ADHD symptoms. As the dosage of Elvanse may increase gradually over a period of months, there is the potential for a patient that has previously tolerated the medication to develop adverse side effects. Monitoring of heart rate and blood pressure may help identify serious side effects at an early stage.

"Symptoms of ADHD can include forgetfulness and problems with inattention. Consequently, there is a risk that patients may not recall verbal advice regarding the adverse side effects of Elvanse, particularly if it is only given at the outset of treatment or is not followed up in writing. The practice of remote consultations may mean that prescribers are reliant upon patients providing heart rate and blood pressure data outside of the consultation. Consequently, there is the potential for clinical decisions to be based on unreliable observations."

The report has been sent to Dr Lade Smith, President of the Royal College of Psychiatrists and Wes Streeting, Minister for Health and Social Care, who both have 56 days to respond.

They have been approached for comment.