Effects of methylphenidate on blood pressure, QT-interval, and cardiac output in ADHD diagnosed children: A three months’ follow-up study

Abstract

Background Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood. It’s been suggested that both the condition and the medications used to treat it can affect the cardiovascular system. This study aims to determine whether methylphenidate has the significant effects in cardiac indices. Methods In this prospective study, 100 newly ADHD-diagnosed children aged 6 to 11 whom all on methylphenidate were included. The demographic, clinical data including the blood pressure and heart rate (HR), echocardiographic, and QT-interval were recorded at baseline and after three months of follow-up. Results After the follow-up period, we observed no abnormal systolic, diastolic, or mean arterial pressure in any of the participants based on their age, height, and gender (p < 0.001). However, the mean of all these variables was significantly increased (p 〈0 0 1). Mean pulse pressure was also higher than baseline but it wasn’t statistically significant (p = 0.059). No significant change was observed in echocardiographic parameters and QT. Conclusion Short-term treatment of ADHD in children with methylphenidate does not have a meaningful relationship with hypertension and increased corrected QT interval. However, an increase in blood pressure and corrected QT interval within a non-pathological range suggests that longer follow-ups may reveal an association.

Methylphenidate-associated chest pain in a child

“…Through the inhibition of dopamine and norepinephrine reuptake, it increases the dopaminergic and noradrenergic activity and increases peripheral systemic vascular resistance 4. This further activates the cardiovascular β-1 adrenoreceptors, resulting in increased heart rate, while activation of α-adrenoreceptors causes vasoconstriction and a rise in blood pressure that may explain the potential risk of cardiovascular events 5–7. These are in line with the Cochrane review that shows an association between methylphenidate use and increased heart rate in the short term 8.…”

Adverse Effects of Stimulant Interventions for Attention Deficit Hyperactivity Disorder (ADHD): A Comprehensive Systematic Review

“…Stimulants like methylphenidate (MPH) and amphetamines (AMP) have consistently shown effectiveness in reducing the core symptoms of ADHD including inattention, hyperactivity, and impulsivity [ 6 ]. These medications work by targeting specific neurotransmitters in the brain that are dysregulated in individuals with ADHD, specifically DA and norepinephrine (NE) [ 14 ]. By enhancing the availability of these neurotransmitters stimulants help improve attention, impulse control, and behavioral regulation [ 27 ].…”

“…The study revealed a substantial increase in BP measurements without affecting the QT interval. Although these changes remained within the normal range during the study duration, the authors suggest there may be a potential for future hypertension [ 14 ]. Additionally, Torres-Acosta et al’s study highlighted a connection between heightened HR and CVD, effectively demonstrating that MPH was linked to increased odds of prehypertension [ 22 ].…”

“…Additionally, they activate adrenergic receptors in the heart and blood vessels which results in slight elevations in resting heart rate (RHR) and blood pressure (BP) [ 13 ]. That’s the reason, among all the available medications for ADHD management, CNS stimulants pose the greatest risk when it comes to cardiovascular (CV) complications [ 14 ]. Thus, it is crucial to determine whether or not observed CV impacts of ADHD medication in a larger population have significant implications for certain individuals, potentially raising their risk for severe CV events like stroke or sudden death [ 1 ].…”