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.

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