Study: Stimulant ADHD Medication Relatively Safe and Effective for Older Adults
Older adults with ADHD largely experience symptom improvement when taking a low dose of stimulant medication, which is well tolerated and does not cause clinically significant cardiovascular changes. This is the finding of a recent study examining the effects of stimulant medication among adults aged 55 to 79 with ADHD, some of whom had a pre-existing cardiovascular risk profile.
June 30, 2020
Stimulant medication may safely and effectively treat attention deficit hyperactivity disorder (ADHD) in older adults when cardiovascular parameters are monitored before and during pharmacological treatment.1 This was the finding of research recently published in the Journal of Attention Disorders that sought to understand the benefits and side effects of stimulant medication use among adults aged 55 to 79 with ADHD.
Researchers at the PsyQ outpatient clinic and the VU University Medical Center in Amsterdam found that nearly two-thirds of adult ADHD patients reported positive results on stimulant medication; though 42% stopped taking medication due to side effects or nonresponse, the study found no “clinically significant cardiovascular changes” among test subjects.
Data was collected from 113 adult ADHD patients in the Netherlands. Blood pressure, heart rate, and weight were measured with T-tests both before and after treatment with ADHD medication. Logistic regression analyses were conducted to assess the relationship between response to medication (yes/no) and each of the following variables:
- type of medication (stimulants vs. non-stimulants)
- use of selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI)
- use of antihypertensive drugs before starting medicine for ADHD
- cardiovascular risk profile as separate independent variables
Pearson’s correlation was used to measure the correlation between methylphenidate (stimulant) dosage and differences in weight, systolic blood pressure, diastolic blood pressure, and heart rate.
Close to 30% of adults in the study had a pre-existing cardiovascular risk profile. Approximately 65% of participants reported positive responses to low-dose stimulant medication. 42% of patients quit the medication due to nonresponse or side effects including anxiety and extreme sadness, cardiovascular complaints, and sleep problems. The study lacked a control group and was observational in nature, so no firm conclusions can be drawn as to the effectiveness of the stimulants used. However, use of a low-dose stimulant was found to be well tolerated and did not cause clinically significant cardiovascular changes among older adults with ADHD, even among those with increased cardiovascular risk profiles. Patients experienced significant and clinically relevant improvement of their ADHD symptoms using stimulants, comparable with what is found among younger age groups.
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1Michielsen, M., Kleef, D., Bijlenga, D., Zwennes, C., Dijkhuizen, K., Smulders, J., … Kooij, J. J. S. (2020). Response and Side Effects Using Stimulant Medication in Older Adults With ADHD: An Observational Archive Study. Journal of Attention Disorders. https://doi.org/10.1177/1087054720925884