Cardiovascular Effects of ADHD Therapies JACC Review Topic of the Week

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:76

Review

Torres-Acosta, Noel¹  O'Keefe, James H.^1,2  O'Keefe, Caroline L.³  Lavie, Carl J.⁴ 

[1] Univ Missouri, Kansas City, MO 64110 USA

[2] St Lukes Mid Amer Heart Inst, Kansas City, MO USA

[3] Tulane Univ, New Orleans, LA 70118 USA

[4] Univ Queensland, Sch Med, Ochsner Clin Sch, John Ochsner Heart & Vasc Inst, New Orleans, LA USA

关键词: ADHD;    amphetamine salts;    amphetamines;    arrhythmia;    atomoxetine;    attention-deficit/hyperactivity disorder;    cardiomyopathy;    cardiotoxicity;    exercise;    lisdexamfetamine;    methylphenidate;    omega-3;    sudden death;   

DOI  :  10.1016/j.jacc.2020.05.081

来源: Elsevier

【 摘 要 】

Although the prevalence of attention-deficit/hyperactivity disorder (ADHD) has been stable over the past 3 decades, prescriptions of sympathomimetic stimulants have steadily increased in the United States. This study consisted of a systematic review of PubMed articles screened for ADHD medications and potential cardiovascular toxicity as well as nondrug strategies for managing ADHD. The cumulative body of data showed that ADHD medications cause modest elevations in resting heart rate and blood pressure. Other adverse effects reported with ADHD stimulants included arrhythmia, nonischemic cardiomyopathy, Takotsubo cardiomyopathy, and sudden death. However, such reports did not imply causation, and there was a paucity of randomized trial evidence addressing long-term safety of ADHD medications, particularly among adults. Further studies are essential to clarify the risks and benefits of ADHD stimulant medications and to explore nonpharmacological options, including regular exercise and omega-3 fatty acids, which could be helpful for improving ADHD symptoms. (C) 2020 Published by Elsevier on behalf of the American College of Cardiology Foundation.

【 授权许可】

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