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The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis

Idrees, Iman; Bellato, Alessio; Cortese, Samuele; Groom, Madeleine J.

Authors

Iman Idrees

Alessio Bellato

Samuele Cortese



Abstract

We carried out a systematic review and meta-analysis to investigate the effects of stimulant and non-stimulant medications on autonomic functioning in people with ADHD (PROSPERO: CRD42020212439). We searched (9th August 2021) PsycInfo, MEDLINE, EMBASE, Web of Science and The Cochrane Library, for randomised and non-randomised studies reporting indices of autonomic activity, (electrodermal, pupillometry and cardiac), pre- and post-medication exposure in people meeting DSM/ICD criteria for ADHD. In the narrative syntheses, we included 5 electrodermal studies, 1 pupillometry study and 57 studies investigating heart rate and blood pressure. In the meta-analyses, 29 studies were included on blood pressure and 32 on heart rate. Administration of stimulants, and to a lesser degree, non-stimulants increased heart rate and blood pressure in people with ADHD. Similarly, an upregulation of arousal, reflected in increased electrodermal activity and pupil diameter was observed following stimulant use. Yet, the methodological diversity of studies presented in this review reinforces the need for more standardised and rigorous research to fully understand the relationship between arousal, medication, and behaviour in ADHD.

Citation

Idrees, I., Bellato, A., Cortese, S., & Groom, M. J. (2023). The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 144, Article 104968. https://doi.org/10.1016/j.neubiorev.2022.104968

Journal Article Type Article
Acceptance Date Nov 19, 2022
Online Publication Date Nov 23, 2022
Publication Date Jan 1, 2023
Deposit Date Dec 8, 2022
Publicly Available Date Dec 15, 2022
Journal Neuroscience & Biobehavioral Reviews
Print ISSN 0149-7634
Electronic ISSN 1873-7528
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 144
Article Number 104968
DOI https://doi.org/10.1016/j.neubiorev.2022.104968
Keywords ADHD; Autonomic; Arousal; Medication; Stimulants; Non-stimulants; Heart rate; HRV; Pupillometry; Electrodermal activity
Public URL https://nottingham-repository.worktribe.com/output/14599302
Publisher URL https://www.sciencedirect.com/science/article/pii/S0149763422004572?via%3Dihub