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Cardiovascular toxicity of stimulants

Posted by kaleidoscope on November 13, 2007, at 15:16:03

In reply to Re: Anyone ever COLD while on RITALIN?? Freezing?, posted by d0pamine on November 13, 2007, at 14:12:25

Long-term use of stimulants may increase the risk of cardiovascular disease. This is a major concern. Stimulants constrict blood vessels and elevate BP. They also increase heart rate and cardiac work. Regular BP monitoring is very important when taking stimulants. High BP causes heart attacks and strokes, even small increases in BP of a few mmHg produce a large increase in risk. In addition, stimulant use has occasionally been associated with strokes and sudden cardiac death in children. Numerous cardiovascular warnings have recently been added to the prescribing information for all stimulants ie. Adderall, Ritalin, Concerta, Dexedrine etc.

Drugs which inhibit the sympathetic nervous system (eg. beta blockers such as Toprol) are used to prevent heart attacks. Stimulants may increase your risk. This important issue has received very little research attention, which is really very poor considering how frequently these drugs are prescribed in the US...... and I say the US because stimulants are used so much less commonly in most countries. The US is without a shadow of a doubt the stimulant capital of the world! I think this has a lot to do with a culture of academic achievement in combination with the widespread medicalisation of normal symptoms which affect most people eg. poor attention, daydreaming, dislike of boring school/college work. Pharmaceutical companies are phenomenally influential in the US and are very very apt at promoting their products.........which are approved based on short-term efficacy studies and lack of long-term safety data. Although stimulants have been used in medicine for decades, their long-term cardiovascular safety has never been properly investigated. In the absense of proper trials, it would be foolish to assume that they are safe, particularly when you consider the effectiveness of drugs which block the effects of the sympathetic nervous system in preventing heart attacks and strokes. In addition, beta blockers and related drugs increase survival in patients with established cardiovascular disease. Given that most cardiovascular disease occurs in adults, and not children, the recent trend toward prescribing stimulants to large numbers of adults with ADHD is a concern.


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