Acute blood pressure change with methylphenidate is associated with improvement in attention performance in children with ADHD

Traicu, Alexandru; Grizenko, Natalie; Fortier, Marie-Ève; Fageera, Weam; Sengupta, Sarojini M.; Joober, Ridha

doi:10.1016/j.pnpbp.2019.109732

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…In our study, we found that ADHD children chronically treated with MPH had closely comparable DBP values, but their SBP values were higher compared to the ADHD children not treated with MPH. It is worth mentioning that the SBP values of ADHD children acutely treated with MPH were also higher than those of ADHD children treated with placebo [56]. Therefore, the higher SBP levels in our study are likely to have been induced by MPH.…”

Section: Blood Pressure In Pediatric Adhd and Potential Effects Of Mphmentioning

confidence: 57%

“…Therefore, the higher SBP levels in our study are likely to have been induced by MPH. Interestingly, the acute SBP increase in MPH-treated ADHD children was found to be associated with improvement in attention performance in these children [56]. On the contrary, ADHD patients with stimulant medication might have a higher frustration rate and suffer from increased stress exposure, which could favor blood pressure dysregulation [57].…”

Section: Blood Pressure In Pediatric Adhd and Potential Effects Of Mphmentioning

confidence: 98%

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Enhanced Nitric Oxide (NO) and Decreased ADMA Synthesis in Pediatric ADHD and Selective Potentiation of NO Synthesis by Methylphenidate

Jansen

Hanusch

Pross

et al. 2020

JCM

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Attention deficit hyperactivity disorder (ADHD) is a common pediatric psychiatric disorder, frequently treated with methylphenidate (MPH). Recently, MPH’s cardiovascular safety has been questioned by observational studies describing an increased cardiovascular risk in adults and blood pressure alterations in children. We considered members of the L-arginine (Arg)/nitric oxide (NO) pathway as possible early cardiovascular risk factors in pediatric ADHD children. They include the NO metabolites, nitrite and nitrate, the NO precursor Arg, and asymmetric dimethylarginine (ADMA), an endogenous NO synthase (NOS) inhibitor and a cardiovascular risk factor in adults. We conducted a prospective clinical trial with 42 ADHD children (aged 6–16 years) with (n = 19) and without (n = 23) MPH treatment. Age-matched children without ADHD (n = 43) served as controls. All plasma and urine metabolites were determined by gas chromatography-mass spectrometry. We observed higher plasma nitrite and lower plasma ADMA concentrations in the ADHD children. MPH-treated ADHD children had higher plasma nitrite concentrations than MPH-untreated ADHD children. As NOS activity is basally inhibited by ADMA, MPH treatment seems to have decreased the inhibitory potency of ADMA. Percentiles of systolic blood pressure were higher in MPH-treated ADHD children. The underlying mechanisms and their implications in the MPH therapy of pediatric ADHD with MPH remain to be elucidated in larger cohorts.

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Section: Blood Pressure In Pediatric Adhd and Potential Effects Of Mphmentioning

confidence: 57%

Section: Blood Pressure In Pediatric Adhd and Potential Effects Of Mphmentioning

confidence: 98%

Enhanced Nitric Oxide (NO) and Decreased ADMA Synthesis in Pediatric ADHD and Selective Potentiation of NO Synthesis by Methylphenidate

Jansen

Hanusch

Pross

et al. 2020

JCM

View full text Add to dashboard Cite

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The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis

Idrees

Bellato

Cortese

et al. 2023

Neuroscience & Biobehavioral Reviews

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Cardiovascular adverse events associated with norepinephrine–dopamine reuptake inhibitors: a pharmacovigilance study of the FDA Adverse Event Reporting System

Kandukuru,

Sharma,

Verghese Gupta

et al. 2024

Can. J. Physiol. Pharmacol.

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Norepinephrine–dopamine reputake inhibitors (NDRIs), including bupropion, methylphenidate, atomoxetine, and reboxetine, are commonly prescribed for psychiatric disorders such as narcolepsy, attention-deficit/hyperactivity disorder, and depression. Cardiovascular adverse events have been reported to the FDA despite their effectiveness. This pharmacovigilance study analyzed cardiovascular adverse events associated with NDRIs using the FDA Adverse Event Reporting System data from January 2004 to December 2021. A retrospective analysis of adverse event reports was conducted, employing time-trend analysis and disproportionality evaluation to assess cardiovascular risks. Bupropion had the greatest reported odds ratios (RORs) for tachycardia (ROR = 4.2, 95% CI: 4.0–4.4) and hypertension (ROR = 3.5, 95% CI: 3.3–3.7), while methylphenidate showed greater ROR for arrhythmias (ROR = 2.8, 95% CI: 2.6–3.0) and palpitations (ROR = 3.1, 95% CI: 2.9–3.3). Reboxetine had signals for palpitations (ROR = 3.0, 95% CI: 2.8–3.2) and myocardial infarction (ROR = 2.7, 95% CI: 2.5–2.9), whereas atomoxetine revealed signals for hypertension (ROR = 2.9, 95% CI: 2.7–3.1) and syncope (ROR = 2.5, 95% CI: 2.3–2.7). Time-trend analysis revealed temporal variability in the cardiovascular risks connected with NDRIs. Our research elucidates cardiovascular safety profiles for NDRIs, highlighting the necessity for continuous pharmacovigilance. The observed variations in adverse events emphasize the need for ongoing surveillance to mitigate potential cardiovascular risks and enhance patient safety and treatment outcomes.

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Acute blood pressure change with methylphenidate is associated with improvement in attention performance in children with ADHD

Cited by 3 publications

References 26 publications

Enhanced Nitric Oxide (NO) and Decreased ADMA Synthesis in Pediatric ADHD and Selective Potentiation of NO Synthesis by Methylphenidate

Enhanced Nitric Oxide (NO) and Decreased ADMA Synthesis in Pediatric ADHD and Selective Potentiation of NO Synthesis by Methylphenidate

The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis

Cardiovascular adverse events associated with norepinephrine–dopamine reuptake inhibitors: a pharmacovigilance study of the FDA Adverse Event Reporting System

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