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Attention Deficit Hyperactivity Disorder

Adderall and blood pressure

07/01/2008

Question:

I am a 22 yr. old male, approx. 5` 11", and 155 lb. In the past I never had blood pressure problems and usually the readings were around 118/72 or so. I recently got prescribed Adderall to help with my concentration. I believe it is 30mg three times a day. I like the medication since it gives me a boost of energy and seems to increase the speed of my mental processes. I guess the only side-effect is a little too much energy and it makes me somewhat nervous and gittery. However, I`ve always been like this in nature and is probably one of the reasons why I enjoy an extremely high metabolism. Anyway, yesterday I decided to get my blood pressure checked just for the sake of doing so. To my surprise the pressure was about 139/84. I started to get pretty concerned and tried out a couple different machines at a couple of different stores. One gave a reading of about 132/81 and one gave me a 98/74 or the such. I can`t quite remember the numbers. I also got it checked again today, by machine, and it came out 140/84. I have scheduled a regular checkup with my doctor for this Friday to get this and some other things checked out. What is your opinion on this issue? Would this have any long term effects? Thank you.

Answer:

Blood pressure is affected by many things. Adderall on average increases BP by 2 to 5 mm of mercury, which is of only minimal importance in most people, but could be more in some susceptible individuals. If one had borderline BP to begin with, 2-5 mm might push it into the abnormal range. Or if you got an overdose, it could push the BP up. Your description of getting a lot of energy from it raises a question about whether your dose may be on the high side. Individuals vary in their optimal dosage. If medication causes a BP rise, it returns to pre-medication levels as the medication wears off once it is stopped. Under 120 systolic and under 80 diastolic are considered normal, with 80-90 diastolic now considered pre-hypertensive. However, this is at rest under controlled conditions. This brings up another reason for BP changes: exertion can drive the systolic number very high. Anxiety can increase both systolic and diastolic BP, and you indicated that you were anxious about it. Endocrine problems (hyperthyroidism, hypercortisolism, etc) can affect BP. You are certainly right to consult with your doctor about it. You might also want to buy one of the cheap automatic machines in a discount store and take it yourself several times a day for a week or two, noting times and readings in a log. This will accomplish several things: you will begin relaxing with it as you get used to the routine, so that if anxiety is driving the borderline readings, they will fall back to normal. Also, any pattern you pick up by time of day or day of week will help your doctor figure out the cause.

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Response by:

L Eugene Arnold, MD, MEd L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University