attention-deficit hyperactivity disorder (ADHD) medication
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Introduction
medication used to treat inattention, including:
- methylphenidate (Ritaline)
- amphetamine (Adderall)
- atomoxetine (Strattera)
- pemoline (Cylert)
Epidemiology
Indications
- inattention
- attention-deficit hyperactivity disorder (ADHD)
- improves academic performance[7]
- reduces risk of motor vehicle accidents[8]
- attention-deficit hyperactivity disorder (ADHD)
Contraindications
- avoid stimulants in patients with serious arrhythmias, symptomatic heart disease, or recent cardiovascular event
Adverse effects
- no increase in cardiovascular risk[1][3]
- potential risk of cardiac arrest & tachyarrhythmias[12]
- stimulant use associated with hypertension, but not arrhythmia or ischemic heart disease[14]
- stimulant use possibly associated with elevated long-term cardiovascular risk[15]
- increase in suicide-related events associated with comorbidities rather than ADHD drug use per se[4]
- linked to poorer sleep in children[5]
- risk taking, poor control of aggression, & substance use[8]
- long-term use into adulthood can stunt growth (up to 2 cm)[6]
* Toxicity
- treat with benzodiazepine
Management
- methylphenidate first line for children
- amphetamine first line for adults[11]
- short-term treatment <= 12 weeks[11]
More general terms
More specific terms
- amphetamine (Mydayis)
- atomoxetine (Strattera)
- methylphenidate (Ritalin, Concerta, Daytrana, Metadate CD, Centedrine)
- pemoline; phenylisohydantoin (Cylert, PIO)
Additional terms
References
- ↑ 1.0 1.1 Habel LA et al. ADHD medications and risk of serious cardiovascular events in young and middle-aged adults. JAMA 2011 Dec 28; 306:2673 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22161946
Shaw P. ADHD medications and cardiovascular risk: Some heartening news. JAMA 2011 Dec 28; 306:2723 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22161945 - ↑ Prescriber's Letter 19(2): 2012 COMMENTARY: Pharmacotherapy of ADHD in Adults CHART: Comparison of Drugs for ADHD Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280226&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 Winterstein AG et al Cardiovascular safety of central nervous system stimulants in children and adolescents: population based cohort study BMJ 2012;345:e4627 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22809800 <Internet> http://www.bmj.com/content/345/bmj.e4627
- ↑ 4.0 4.1 Chen Q et al Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. BMJ 2014;348:g3769 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24942388 <Internet> http://www.bmj.com/content/348/bmj.g3769
- ↑ 5.0 5.1 Orciari Herman A, Sadoughi S, Sofair A ADHD Meds Tied to Poorer Sleep in Children Physician's First Watch, Nov 23, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org (reference to pediatrics article)
- ↑ 6.0 6.1 Davenport l Long-term ADHD Med Use: No Benefit, Negative Impact on Growth. Medscape - Mar 20, 2017. https://www.medscape.com/viewarticle/877438
Swanson JM, Arnold LE, Molina BSG et al Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression. J Child Psychol Psychiatry. 2017 Jun;58(6):663-678. Epub 2017 Mar 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28295312 - ↑ 7.0 7.1 Brauser D Medications Boost Academic Performance in ADHD Patients. Medscape - Jul 07, 2017. https://www.medscape.com/viewarticle/882597
Lu Y, Sjolander A, Cederlof et al Association Between Medication Use and Performance on Higher Education Entrance Tests in Individuals With Attention-Deficit/ Hyperactivity Disorder. JAMA Psychiatry. 2017 Aug 1;74(8):815-822. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28658471 - ↑ 8.0 8.1 8.2 Yasgur BS ADHD Medications Reduce Risk for Motor Vehicle Crashes. Medscape - May 12, 2017. https://www.medscape.com/viewarticle/879929
Chang Z, Quinn PD, Hur K et al Association Between Medication Use for Attention-Deficit/ Hyperactivity Disorder and Risk of Motor Vehicle Crashes. JAMA Psychiatry. 2017 Jun 1;74(6):597-603. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28492937 - ↑ Melville NA Experimental ADHD Drugs Aimed at Aggression, Genetic Targets. Medscape - Jun 09, 2017. https://www.medscape.com/viewarticle/881351
- ↑ 10.0 10.1 Anderson KN, Ailes EC, Danielson M, et al. Attention-Deficit/Hyperactivity Disorder Medication Prescription Claims Among Privately Insured Women Aged 15-44 Years - United States, 2003-2015. MMWR Morb Mortal Wkly Rep 2018;67:66-70 https://www.cdc.gov/mmwr/volumes/67/wr/mm6702a3.htm
Brooks M ADHD Prescriptions Skyrocket Among Young Women. Medscape - Jan 18, 2018. https://www.medscape.com/viewarticle/891501 - ↑ 11.0 11.1 11.2 Cortese S, Adamo N, Del Giovane C et al Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry. Aug 7, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30097390 Free Article https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30269-4/fulltext
- ↑ 12.0 12.1 Zhang L, Yao H, Li L et al Risk of Cardiovascular Diseases Associated With Medications Used in Attention-Deficit/Hyperactivity Disorder. A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(11):e2243597 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36416824 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798903
- ↑ Torres-Acosta N, O'Keefe JH, O'Keefe CL Cardiovascular Effects of ADHD Therapies: JACC Review Topic of the Week. Lavie CJ. J Am Coll Cardiol. 2020 Aug 18;76(7):858-866. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32792083 Free article.
- ↑ 14.0 14.1 Zhang L et al. Attention-deficit/hyperactivity disorder medications and long-term risk of cardiovascular diseases. JAMA Psychiatry 2024 Feb 1; 81:178. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37991787 PMCID: PMC10851097 Free PMC article https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2811812
- ↑ 15.0 15.1 Holt A et al Long-Term Cardiovascular Risk Associated With Treatment of Attention-Deficit/ Hyperactivity Disorder in Adults. J Am Coll Cardiol. 2024 May 14;83(19):1870-1882. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38719367