Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects millions worldwide. To manage its symptoms, numerous individuals rely on medications. The pharmaceutical industry, often termed "Big Pharma," has played a significant role in the development and promotion of these drugs. However, the long-term effects of these medications remain a topic of discussion and research.

Stimulant Medications

The most commonly prescribed medications for ADHD are stimulants. These include methylphenidate-based drugs (e.g., Ritalin, Concerta) and amphetamine-based drugs (e.g., Adderall, Vyvanse).

Methylphenidate-based Drugs

  • Effects on the Brain: Over time, chronic use of methylphenidate has been associated with changes in brain structure. One study found that children treated with this drug had a slightly thicker cortex, particularly in areas associated with attention (Shaw et al., 2009). However, the clinical significance of this change remains uncertain.

  • Growth: There have been concerns about growth suppression in children taking stimulant medications. Some studies suggest that there might be a slight reduction in height and weight gain, especially in the first years of treatment, but the long-term significance of this is debated (Swanson et al., 2007).

Amphetamine-based Drugs

  • Cardiovascular Effects: Concerns have been raised about potential cardiovascular risks associated with amphetamine use. Some studies have shown a modest increase in blood pressure and heart rate (Vitiello, 2008). However, the clinical significance of these findings in the general ADHD population is unclear, although caution is advised for individuals with pre-existing heart conditions.

  • Potential for Misuse: Among older adolescents and college students, there's a documented potential for misuse of these drugs, especially in the context of academic performance enhancement (Wilens et al., 2008).

Non-Stimulant Medications

Non-stimulant medications, such as atomoxetine (Strattera) and guanfacine (Intuniv), are also used to treat ADHD.

  • Liver Function: Atomoxetine has been associated with liver injury in a small number of cases. As a result, monitoring liver enzyme levels is recommended for patients exhibiting signs of liver problems (Wernicke et al., 2006).

  • Blood Pressure and Heart Rate: Guanfacine can impact cardiovascular parameters, leading to potential decreases in heart rate and blood pressure (Sallee et al., 2009).

Long-Term Mental Health Implications

The potential for ADHD medications to affect mental health over extended use is a topic of concern. Some studies suggest that the use of stimulant medications might slightly increase the risk of developing anxiety or depression in adulthood, but this area requires further research (Humphreys et al., 2019).

The Need for Longitudinal Studies

One of the challenges in understanding the long-term effects of ADHD medications is the lack of comprehensive longitudinal studies. Most studies focus on short-term effects, with only a few extending beyond a couple of years. Long-term studies are essential for a complete understanding of potential risks and benefits (Molina et al., 2009).


The long-term effects of ADHD medications remain a topic of ongoing research. Current data suggests that while these drugs can be effective in managing ADHD symptoms, potential risks exist. It's essential for patients and healthcare providers to engage in informed discussions, weighing the benefits against potential long-term consequences.


  1. Shaw, P., et al. (2009). Long-term effects of methylphenidate on cortical thickness in children with attention deficit hyperactivity disorder. Biological Psychiatry, 66(3), 216-223.
  2. Swanson, J.M., et al. (2007). Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 46(8), 1015-1027.

  3. Vitiello, B. (2008). Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function. Child and Adolescent Psychiatric Clinics, 17(2), 459-474.

  4. Wilens, T.E., et al. (2008). Misuse and diversion of stimulants prescribed for ADHD: A systematic review of the literature. Journal of the American Academy of Child & Adolescent Psychiatry, 47(1), 21-31.

  5. Wernicke, J.F., et al. (2006). Liver-related events in atomoxetine-treated patients: A retrospective cohort assessment. Journal of Clinical Psychopharmacology, 26(6), 614-619.

  6. Sallee, F.R., et al. (2009). Guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: A placebo-controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48(2), 155-165.

  7. Humphreys, K.L., et al. (2019). Stimulant medication and substance use outcomes: A meta-analysis. JAMA Psychiatry, 76(7), 740-750.

  8. Molina, B.S.G., et al. (2009). The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 484-500.