A coroner has urged a review following the death of a young City finance worker of heart issues just days after his ADHD medication dosage was increased.
Coroner Sarah Bourke has called on the Government to launch an inquiry into Elvanse, which she described as ‘increasingly being prescribed in the NHS‘.
The new warning over the ADHD medication comes following the death of banker and musician Jacob Wooderson.
The 28-year-old collapsed and died at his London home having recently started taking Elvanse, the brand name for Lisdexamfetamine.
The financial analyst, who was educated at one of the UK’s oldest private schools, had been diagnosed with ADHD six months before his death in August last year.
His Elvanse dosage was increased and he experienced ‘exhaustion’ before eventually dying.
Ms Bourke, coroner for London Inner North, told how Elvanse was an amphetamine-based medicine and could have ‘fatal cardiac side effects’.
Patients such as Mr Wooderson can develop adverse side effects when their dosage is increased, Ms Bourke warned.
Banker and musician Jacob Wooderson (pictured), 28, died in August last year
The financial analyst, who was educated at one of the UK’s oldest private schools, had been diagnosed with ADHD six months before his death
Coroner Sarah Bourke has called on the Government to launch an inquiry into Elvanse, which she described as ‘increasingly being prescribed in the NHS’
Mr Wooderson died on August 23 last year, with his two causes of death listed as sudden arrhythmic death syndrome and Elvanse treatment for ADHD.
His family, from Hereford, where he attended Hereford Cathedral School, said he was ‘warm and caring’ and ‘made everyone feel special and seen’.
In a Prevention of Future Deaths report, Ms Bourke said: ‘He was diagnosed by a privately instructed Consultant Psychiatrist as having ADHD (inattentive subtype presentation) in February 2024.
‘He subsequently commenced Elvanse (Lisdexamfetamine) 30 mg. 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. He collapsed and died at his home on 23 August 2024.’
It is not clear whether the arrhythmia that Mr Wooderson experienced had a genetic cause or was solely due to the medication.
Mr Wooderson died on August 23 last year, with two causes of death listed as sudden arrhythmic death syndrome and also Elvanse treatment for ADHD
Ms Bourke said there were failings due to ‘missed opportunities’.
She added: ‘Jacob Wooderson 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.
‘Toxicology evidence established that Elvanse (lisamphetamine) 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 and particularly at the start of a new treatment (e.g. increased dosage) due to tolerance to that dose not being formed.
‘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 70mg.
Patients such as Mr Wooderson (pictured) can develop adverse side effects when their ADHD dosage is increased, coroner Sarah Bourke has warned
‘Jacob increased his Elvanse dosage from 50 mg to 70 mg around 6 August 2024.
‘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 70mg, they would have advised him to stop taking Elvanse and reviewed his medication.’
Ms Bourke warned that more people with ADHD are at risk of dying, concluding: ‘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.
Tributes have been shared online to Jacob Wooderson following his death aged 28 last year
‘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.’
Her report was issued to the Royal College of Psychiatrists and health secretary Wes Streeting.
Following Mr Wooderson’s death, his family said on a tribute page: ‘Jacob embraced life fully and unapologetically.
‘He had so many people in his life that he left an impact on, who truly loved and valued him. 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.
He was described as someone who ’embraced life fully and unapologetically’
‘Music was a huge part of Jacob’s life, either playing his clarinet or piano, tapping his knee to some music blaring through his headphones, or dancing around at a concert.
‘Jacob was completely authentic and true to himself in every aspect of his life, from his career, to relationships and his emotions.
‘He had a natural way of making everyone feel heard and seen. He cared deeply about the happiness of others and always made sure he was putting his best self out into the world.
‘As a son, brother, friend, and boyfriend, Jacob had a remarkable ability to make people feel at home.
‘His presence was always a source of comfort, laughter, and support. Those who were lucky enough to know him will carry these memories with them always, in the music he loved, the laughter he sparked, and the fearless way he lived his life.’
A funeral notice said he left behind parents Roland and Marnie, brother Joshua and his partner Noemie.
A LinkedIn profile suggests he was an analyst in London who previously worked for JP Morgan.