Long-Term Cardiovascular Effects of Medications for Attention-Deficit/Hyperactivity Disorder—Balancing Benefits and Risks of Treatment
Samuele Cortese, Cristiano Fava
Abstract
Will this medication have negative effects in the short and long term?<br/><br/>This is a very common question clinicians encounter when discussing the option of starting a pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD), which includes stimulants (methylphenidate and amphetamines) and nonstimulants (eg, atomoxetine, clonidine, guanfacine, and viloxazine).1 Concerns about cardiovascular risk associated with ADHD medications, particularly stimulants, are among the most serious ones. Indeed, as stimulants are sympathomimetic agents with dopaminergic and noradrenergic effects, increased values of heart rate and blood pressure after treatment are plausible from a biological standpoint.1 In turn, over the long term, sustained increases in heart rate and blood pressure might result in left ventricular hypertrophy and an elevated risk of myocardial infarction.