Medications	Mechanism of action	Cardiac effects and comments	Recommendations for cardiovascular monitoring
			Class I, level of evidence C*	Class IIa, level of evidence C*
Methylphenidate (Ritalin), dexmethylphenidate (Focalin)	Release and/or inhibit reuptake of catecholamines (e.g., dopamine, norepinephrine); increase level of neurotransmitters at the synapse	Increased HR and BP; no ECG changes	BP, HR	ECG on first visit
Amphetamine/dextro-amphetamine (Adderall), dextroamphetamine (Dexedrine), lisdexam-fetamine (Vyvanse)	Release and/or inhibit reuptake of catecholamines; increase level of neurotransmitters at the synapse	Increased HR and BP; no ECG changes	BP, HR	ECG on first visit
Atomoxetine (Strattera)	Selective norepinephrine reuptake inhibitor	Increased HR and BP in adults and children; palpitations in adults; no ECG changes	BP, HR	ECG on first visit
Clonidine (Catapres)	Alpha2-adrenergic agonist	Decreased HR and BP; no ECG changes; rebound hypertension with abrupt discontinuation	BP, HR; additional BP when medication is started and weaned	ECG on first visit
Guanfacine (Tenex)	Alpha2-adrenergic agonist	Decreased HR and BP; no ECG changes	BP, HR	ECG on first visit
Desipramine (Norpramin), imipramine (Tofranil)	Block the reuptake of dopamine and norepinephrine	Prolongation of QTc, PR, QRS, tachycardia; rare reports of sudden death	BP, HR	Baseline ECG and at dose increases
				PR ≤ 200 milliseconds
				QRS ≤ 120 milliseconds
				QTc ≤ 460 milliseconds
Bupropion (Wellbutrin)	Decreased firing rate of norepinephrine- and serotonin-releasing neurons	Increased BP in adults (not in children); cardiac toxicity with overdose	BP, HR	ECG on first visit