ADHD drugs have minimal impact on heart health in large studies

A new study led by the University of Southampton found that ADHD medications have a small overall effect on blood pressure and heart rate after weeks or months.

There have been concerns about the side effects of ADHD drugs, but new findings, combined with other studies, suggest that the benefits of taking these drugs outweigh the risks and highlight the need for careful monitoring.

Research published in Rancet Psychiatrybased on the results of randomized controlled trials, we conducted the largest and most comprehensive analysis of the cardiovascular effects of ADHD drugs. This is the most rigorous type of clinical study to assess drug efficacy.

When it comes to taking medication, risk and benefits must always be evaluated together. We found a slight overall increase in blood pressure and pulse for the majority of children taking ADHD medications.

Other studies have shown clear benefits in terms of lower risk of death and improved academic functioning, and a slight increase in the risk of hypertension, but no other cardiovascular diseases. Overall, the risk-benefit ratio is comforting for people taking ADHD medications. ”

Professor Samuel Cortese, Senior Author of Research at the University of Southampton

This research was funded by Dr. Louis Farhatt (University of Sao Paulo, Brazil) as the first author and Professor Alexis Rebett (France, France, France, France) as co-author within the framework of the NIHR Research Professor Scheme for Professor Samuere Cortez.

Presumed to be attentive deficit/hyperactivity disorder (ADHD) affects approximately 4% of children in the UK. Of these, approximately 45% are treated with medication.

An international team of investigators 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 allows for comparison of the effectiveness of several drugs even when drugs were not directly compared in the trials included in the analysis.

They found that all ADHD medications are generally associated with a small overall effect on blood pressure, heart rate, and ECG parameters. Other drugs have led to an increase in the values ​​of these parameters, with the exception of guan facin (which leads to lower blood pressure and lower heart rate).

No significant differences were found between stimulants (including methylphenidate and amphetamine) and non-stimulants (atomoxetine and biloxazine) regarding the effects on blood pressure and heart rate.

“Our findings highlight the need to systematically monitor blood pressure and heart rate for both meth and non-stimulants and provide information to future clinical guidelines. This should be particularly relevant to practitioners who may assume that meth alone has a negative effect on the cardiovascular system,” Dr. Farhatt said.

Researchers say people with existing heart disease should discuss with a specialized cardiologist about the side effects of ADHD medications before starting treatment.

Professor Revet said, “Our findings based on randomized controlled trials that tend to be shorter due to ethical issues should be supplemented by results from actual long-term studies.”

The researchers now check whether some groups are more vulnerable to cardiovascular side effects than others.

Cortese, a research professor at NIHR, concluded: “While our findings are beneficial at the group level, we cannot rule out that, on average, subgroups of individuals may be at a higher risk of more substantial cardiovascular changes.

“It is currently impossible to identify individuals at higher risk, but we hope that efforts based on a precision medical approach will provide important insights in the future.”

Comparative cardiovascular safety for attention deficit/hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis It is published on Lancet Psychiatry Available online.