ADHD Medication: Should Antihypertensive Drugs Be Used?

In the 1980’s, several published research papers suggested that antihypertensive drugs can be used to effectively manage ADHD symptoms, particularly hyperactive behavior and violent tendencies. It was found that anti-hypertensive drugs clonidine and guanfacine can improve the brain’s use of dopamine and inhibit the production of too much norepinephrine. Clonidine was also discovered to be better than stimulants at reducing hyperactivity, impulsivity, and mood swings. But are these ADHD medications necessarily safer than stimulant drugs?

There are many kinds of drugs that reduce blood pressure through different mechanisms. Some reduce the vigor of heart contractions while others lower the amount of fluid in the blood. The anti-hypertensive medications for ADHD lower blood pressure by affecting the nervous system. To be specific, they prevent the release of norepinephrine, the neurotransmitter that boosts heart rate when the body’s fight or flight response gets activated. By inhibiting norepinephrine’s release, the medicine can calm down a hyperactive child.

It’s very likely that the desirable effects of anti-hypertensive drugs are due to its sedative properties; drowsiness and fatigue are two of the most common side effects of clonidine. Studies also show that these medicines do not improve short attention spans and productivity. To combat this, there was a trend where doctors prescribed anti-hypertensives with the stimulant methylphenidate, found in the popular ADHD drug Ritalin. Unfortunately, this practice resulted in the death of several children. Although a medical investigation was unable to come up with evidence that the deaths were due to these drugs, many prominent doctors started questioning the value of treating ADHD with antihypertensives and methylphenidate, considering that its long-term effects and safety are poorly studied.

When used alone, anti-hypertensive medications may have some potentially worrisome side effects. Since these drugs are designed to prevent hypertension, the drug may cause low blood pressure and interferes with heartbeat, which may increase the risk of heart conditions. Its sedative effects can also impair thinking and slow down motor skills, which pose safety problems for ADHD sufferers who drive or operate heavy machinery. On the other hand, anti-hypertensive medications do not have the addictive potential of stimulants and will not cause heart failure by itself.

Of all the medications used to treat ADHD, anti-hypertensives seem to have the least dangerous risks. However, these risks are very real and still have the potential to be life-threatening. Consider the pros and cons very carefully before deciding to treat your child’s ADHD with medication.