Attention-deficit/hyperactivity disorder (ADHD) is a common condition that affects both children and adults.
People with ADHD may find it hard to pay attention, stay organized, sit still, or control impulsive behavior.
These symptoms can affect learning, work, relationships, and everyday life.
For many people, medication is an important part of treatment because it can improve focus, reduce hyperactivity, and make daily activities easier.
However, some parents and patients worry that ADHD medicines may harm the heart.
A new international study has provided reassuring news. Researchers led by the University of Southampton found that ADHD medications usually cause only small increases in blood pressure and heart rate after several weeks or months of treatment.
The researchers say that, for most people, the benefits of taking these medicines are greater than the small risks, especially when doctors regularly monitor patients during treatment.
The research was published in The Lancet Psychiatry and is the largest and most detailed study so far to examine how ADHD medicines affect the heart and blood circulation. The team analyzed data from 102 randomized controlled trials involving more than 22,000 children, teenagers, and adults with ADHD.
Randomized controlled trials are considered one of the most reliable ways to test whether medicines are effective and safe because they compare treatments under carefully controlled conditions.
The researchers came from the United Kingdom, Brazil, and France. They used a statistical method called a network meta-analysis. This method allowed them to compare several ADHD medicines at the same time, even when two drugs had not been directly compared in the same clinical trial.
The results showed that most ADHD medicines caused only small increases in blood pressure, heart rate, and changes on electrocardiograms (ECGs), which are tests that measure the heart’s electrical activity. One medicine, guanfacine, was different because it slightly lowered blood pressure and heart rate instead.
The study also found that stimulant medicines, such as methylphenidate and amphetamine-based drugs, did not appear to have larger effects on the heart than non-stimulant medicines such as atomoxetine and viloxazine. This means that both groups of medicines had broadly similar effects on blood pressure and heart rate.
Professor Samuele Cortese, the senior author of the study, said every medicine has both benefits and risks, and doctors should always consider both before starting treatment.
Previous research has shown that ADHD medicines can improve school performance, reduce ADHD symptoms, and may even lower the risk of early death in people with ADHD. Although these medicines can slightly increase the chance of developing high blood pressure, the overall balance of evidence suggests that the benefits usually outweigh the risks.
Dr. Luis Farhat, the first author of the study, said the findings should help improve future treatment guidelines. He stressed that doctors should continue checking blood pressure and heart rate before treatment begins and during follow-up visits. Regular monitoring helps identify the small number of people who may develop larger changes.
The researchers also advised that people who already have heart disease or other serious heart conditions should speak with a heart specialist before starting ADHD medication. This can help doctors choose the safest treatment and decide how closely the patient should be monitored.
Professor Alexis Revet, one of the senior authors, noted that most clinical trials only last a short time because of ethical and practical reasons. As a result, more long-term studies are still needed to understand how ADHD medicines affect the heart over many years.
The research team now plans to investigate whether certain people are more likely to experience stronger side effects. Professor Cortese believes future precision medicine approaches may help identify those individuals so treatment can be tailored to each person’s needs.
Overall, the findings should reassure many families. For most people with ADHD, these medicines appear to have only small effects on heart health when used under medical supervision.
Regular check-ups remain an important part of safe treatment, allowing doctors to make changes if needed while helping patients receive the benefits of effective ADHD care.
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The study was published in The Lancet Psychiatry.
