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Topics:
General Internal Medicine • Psychiatry • Consultation-Liaison Psychiatry • General Outpatient Psychiatry • General Geriatric Medicine • ADHD • General Primary Care
How do you balance the risks and benefits of stimulant treatment in patients with poorly controlled hypertension?
How do you weigh cardiovascular risks against the potential functional and emotional consequences of undertreated ADHD? What blood pressure thresholds or clinical factors prompt you to reduce or discontinue stimulants? Have you found particular strategies (e.g., dose timing, non-stimulant alternatives, close collaboration with primary care) helpful in mitigating risk?
Answer from: at Academic Institution
The short answer is that there are no clear cutoffs to clearly guide management, and often decisions are guided by shared decision making with patients and relevant specialties (psychiatry, primary care, cardiology).Clinical factors which may prompt you to stop or reduce stimulants:
Elevated BP tha...
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Answer from: at Community Practice
The question of how to balance stimulant therapy with uncontrolled hypertension remains one of the more challenging clinical crossroads in contemporary psychiatric practice. While stimulants are among the most effective treatments for ADHD, they also carry well-documented cardiovascular risks. When ...