title: A cardiopulmonary study of lisdexamfetamine in adults with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  Due to concerns about the safety of stimulants for ADHD, novel assessments of the cardiopulmonary impact of these agents are needed.
  
  
  METHODS
  An open design of lisdexamfetamine (LDX) in 15 adults with DSM-IV ADHD. Following a psychiatric evaluation and medical history, subjects underwent echocardiography (TTE) and cardiopulmonary exercise testing (CPET). LDX was titrated to 70 mg daily over 6 weeks, followed by monthly visits to 6 months. Change in TTE and CPET measures were examined following up to 6 months of LDX.
  
  
  RESULTS
  At endpoint, there were no significant alterations in indices of cardiac systolic performance, or in metabolic and ventilatory variables at maximum exertion (P values >0.05). We found significant mean changes in resting LV systolic dimension and Doppler diastolic indices. Change in heart rate recovery at 1 min met statistical significance (P = 0.05).
  
  
  CONCLUSIONS
  We did not detect clinically meaningful changes in cardiac structure and function or in metabolic and ventilatory variables at maximum exertion in ADHD adults receiving open LDX. The clinical significance of changes in resting LV dimension and indices of diastolic function are not in the direction of cardiomyopathy. Future large sample controlled study can examine these findings, as well as stimulants' impact on heart rate recovery.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital (MGH), Cambridge, MA 02138, USA. phammerness@partners.org
authors.forename: Paul
authors.initials: P
authors.lastname: Hammerness
authors.forename: Randall
authors.initials: R
authors.lastname: Zusman
authors.forename: David
authors.initials: D
authors.lastname: Systrom
authors.forename: Craig
authors.initials: C
authors.lastname: Surman
authors.forename: Aaron
authors.initials: A
authors.lastname: Baggish
authors.forename: Mary
authors.initials: M
authors.lastname: Schillinger
authors.forename: Rachel
authors.initials: R
authors.lastname: Shelley-Abrahamson
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000494:pharmacology* / Q000627:therapeutic use; D003913:Dextroamphetamine / Q000494:pharmacology* / Q000627:therapeutic use; D004452:Echocardiography; D005080:Exercise Test / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D000069478:Lisdexamfetamine Dimesylate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000697:Central Nervous System Stimulants; D000069478:Lisdexamfetamine Dimesylate; D003913:Dextroamphetamine