ADHD Medications Have Minimal Impact on Heart Health in Large Study

ADHD Medications Have Minimal Impact on Heart Health in Large Study

A new study from the University of Southampton has found that medication for ADHD has little effect on blood pressure and heart rate overall after weeks or a few months.

There have been concerns about the side effects of ADHD medications, but the new results, coupled with other studies, suggest that the benefits of these medications outweigh the risks while highlighting the need for careful monitoring.

The study, published inThe Lancet Psychiatryconducted the largest and most comprehensive analysis of the cardiovascular effects of ADHD medications based on the results of randomized controlled trials – the most rigorous clinical trial evaluating drug effects.

When it comes to taking medication, risks and benefits should always be evaluated together. The majority of children taking ADHD medication found small increases in blood pressure and impulse.

Other studies show clear benefits in reducing mortality risk and improving academic functioning, as well as a small increased risk of hypertension but not other cardiovascular diseases. Overall, the risk-benefit ratio for people taking ADHD medication is reassuring. “

Professor Samuele Cortese, senior author of the study, University of Southampton

The study was funded by the National Institute for Health and Care Research (NIHR) under the NIHR Research Professorship Scheme to Professor Samuele Cortese. Dr. Luis Farhat (University of São Paulo) as first author and Professor Alexis Revet (University of Toulouse, France, France) as co-senior author.

It is estimated that attention deficit hyperactivity disorder(ADHD) affects around 4 percent of children in the UK. Of these, around 45 percent are treated with medication.

The international research team analyzed data from 102 randomized controlled trials, including a total of 22,702 participants with ADHD. They used an advanced statistical approach - network meta-analysis - that allowed them to compare the effects of multiple drugs, even if the drugs were not directly compared in the studies included in the analysis.

They found that all ADHD medications were generally associated with small small effects on blood pressure, heart rate, and ECG parameters. With the exception of guanfacine (which leads to reduced blood pressure and heart rate), other drugs caused an increase in the values ​​of these parameters.

No significant differences were found between stimulants (including methylphenidate and amphetamine) and non-stimulants (atomoxetine and viloxazine) in their effects on blood pressure and heart rate.

"Our findings should inform future clinical guidelines and emphasize the need to systematically monitor blood pressure and heart rate for stimulant and non-stimulant drugs. This should be particularly relevant to practitioners who may assume that only stimulant drugs have a negative impact on the cardiovascular system," said Dr. Farhat.

The researchers say those with existing heart disease should discuss the side effects of ADHD medications with a specialist cardiologist before starting treatment.

Professor Revet added: "Our findings, which are based on randomized controlled trials, which are typically short-duration due to ethical issues, should be complemented by results from longer-term, real-world studies."

The research team will now look at whether some groups are more susceptible to cardiovascular side effects than others.

NIHR Research Professor Cortese concluded: “While our results are informative at a group level, on average we cannot rule out the possibility that a subgroup of people are at higher risk of more extensive cardiovascular changes.

“While it is not currently possible to identify these higher-risk individuals, efforts based on precision medicine approaches will hopefully provide important insights in the future.”

Comparative cardiovascular safety of medications for attention-deficit/hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysiswill be published inThe Lancet Psychiatryand is available online.

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