Side Effects of Adderall: Blood Pressure, Heart Rate and More

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While Adderall and its extended-release formulation (Adderall XR) have been shown to cause modest increases in blood pressure and heart rate, these changes are generally not clinically significant in the short or long term for most patients. However, given the potential for cardiovascular effects, it is crucial for healthcare providers to monitor these parameters regularly, especially in pediatric patients. This ensures that any significant changes can be addressed promptly to mitigate potential risks.

Adderall, a commonly prescribed medication for attention-deficit/hyperactivity disorder (ADHD), has been the subject of numerous studies due to its potential side effects, particularly concerning cardiovascular health. This article delves into the effects of Adderall on blood pressure, heart rate, and other related cardiovascular parameters.

Blood Pressure

Short-Term Effects

Research has shown that the short-term cardiovascular effects of Adderall are generally modest. A study involving youths aged 4 to 17 years treated with Adderall or methylphenidate (MPH) found no clinically significant changes in resting pulse, diastolic blood pressure, or systolic blood pressure after one week at various doses (5 mg, 10 mg, or 15 mg)1. This suggests that short-term use of Adderall at these doses does not necessitate specific cardiovascular monitoring.

Long-Term Effects

In a more extended study, children aged 6 to 12 years were treated with mixed amphetamine salts extended-release (MAS XR; Adderall XR) for up to two years. The study found that the mean increases in systolic blood pressure (3.5 mm Hg) and diastolic blood pressure (2.6 mm Hg) were clinically insignificant, with no apparent dose-response relationship2. This indicates that long-term use of Adderall XR at doses up to 30 mg/day has minimal cardiovascular impact in otherwise healthy children.

Heart Rate

Short-Term Effects

The same short-term study mentioned earlier also reported no significant changes in heart rate among youths treated with Adderall1. This aligns with the findings of another study that assessed the short-term cardiovascular effects of MAS XR, which also found no statistically significant differences in heart rate changes compared to placebo2.

Long-Term Effects

Over a two-year period, the long-term study on MAS XR reported a mean increase in pulse rate of 3.4 beats per minute (bpm), which was deemed clinically insignificant2. This suggests that long-term treatment with Adderall XR does not significantly affect heart rate in children.

Comparative Analysis with Other ADHD Medications

A systematic review and meta-analysis evaluated the cardiovascular effects of various ADHD medications, including methylphenidate (MPH), amphetamines (AMP), and atomoxetine (ATX). The analysis revealed that all three medications were associated with small but statistically significant increases in systolic blood pressure. Specifically, AMP and ATX treatments were linked to small increases in diastolic blood pressure and heart rate, while MPH had a significant effect only on systolic blood pressure3. This highlights the need for close and regular monitoring of blood pressure and heart rate in pediatric patients using these medications, as even small increases can be clinically significant for some individuals.