Heart Palpitations on Adderall, Vyvanse or Other ADHD Medication: What to Do

Creator: Ryan S. Sultan, MD
Published: 2026-11-12

By Ryan S. Sultan, MD
Psychiatrist · Columbia University Irving Medical Center
Published November 12, 2026 · 6-minute read

Palpitations, the sensation of a pounding or racing heartbeat, were reported by 3% of adults taking Concerta and 1% of adults taking placebo in the trials summarized in its label.¹ In the adult Adderall XR trial, palpitation was among the reactions reported by 2 to 4% of patients, at a higher rate than placebo.²

Palpitations with chest pain, fainting or shortness of breath are an emergency: call 911 or go to an emergency department. Palpitations without those symptoms should be reported to the prescriber, who can check pulse and blood pressure. Any change in dose is made with the prescriber.

How much Adderall, Vyvanse and other stimulants raise heart rate

The Adderall XR, Vyvanse and Concerta labels give the same average for stimulants as a class: heart rate rises by about 3 to 6 beats per minute. The Vyvanse and Concerta labels add that some patients may have larger increases.^{2, 3, 1} I've covered the averages for each medication in effects of ADHD medication on the heart.

A meta-analysis of 10 placebo-controlled stimulant trials in adults found that resting heart rate was 5.7 beats per minute higher on medication than on placebo (95% CI, 3.6 to 7.8). In the six trials that reported it, a resting heart rate above 90 beats per minute was recorded in 4.2% of adults on a stimulant and 1.7% on placebo.⁴

The 90 figure is the threshold those researchers used to count outliers. The stimulant labels cited here give no heart-rate number that separates safe from unsafe, so a reading of 100 or 120 has to be interpreted by a clinician who knows the patient's baseline and symptoms.

In the same meta-analysis, 1.5% of adults on a stimulant (22 of 1,514) and 0.8% on placebo (5 of 630) discontinued because of cardiovascular symptoms, a difference that was not statistically significant.⁴

In children followed for 10 years in the MTA study, stimulant medication did not increase the risk of tachycardia, although greater cumulative exposure was associated with a higher heart rate at years 3 and 8.⁵

How often palpitations are reported, by medication

Palpitations and tachycardia in adult placebo-controlled trials
Medication	Palpitations	Tachycardia
Concerta (methylphenidate)	3% on medication, 1% on placebo	5% on medication, 0% on placebo
Adderall XR (mixed amphetamine salts)	Reported by 2 to 4%, more often than on placebo	6% on medication, 3% on placebo
Vyvanse (lisdexamfetamine)	2% on medication, 0% on placebo	Increased heart rate: 2% on medication, 0% on placebo
Atomoxetine (Strattera)	3.7% on medication, 0.8% on placebo	No figure in the sources used here

Sources: Concerta, Adderall XR and Vyvanse prescribing information; Wernicke and colleagues, 2003.^{1, 2, 3, 6} The figures come from separate trials and are not a comparison between medications.

These were symptoms that patients described. In the atomoxetine analysis they were subjective reports of palpitations since the last weekly visit, and the authors wrote that because Holter monitoring was not part of the studies, "the cardiac electrophysiology associated with these events is not known."⁶

In children and adolescents, a pooled analysis of 18 trials counted a cardiovascular adverse effect of any kind in 12.6% of 5,837 participants: 12.7% in methylphenidate studies and 12.5% in amphetamine studies. That count includes raised blood pressure and heart rate as well as palpitations. In those trials 2% of patients stopped medication because of a cardiovascular effect, and in the majority the effects resolved spontaneously, the dose was changed, or the effects were not considered clinically relevant.⁷ A 2011 review estimated that 5 to 15% of treated children and adolescents may have a larger rise in heart rate or blood pressure at a given visit or may report a cardiovascular-type complaint.⁸

In one study, arrhythmia diagnoses were as elevated before the first prescription

Three registry studies of young people cited here examined arrhythmia diagnosis codes. In South Korean children and adolescents taking methylphenidate, the rate of an arrhythmia diagnosis was 1.61 times higher during treatment (95% CI, 1.48 to 1.74) and highest on days one to three after starting (2.01; 1.74 to 2.31). The authors judged the absolute risk likely to be low.⁹

A 2026 study of children and adolescents in Taiwan used the same design and added a look at the 60 days before the first methylphenidate prescription. The rate ratio for arrhythmia was 1.41 during treatment (95% CI, 1.21 to 1.63) and 1.50 in the pre-prescription period (1.15 to 1.96). After 56 days of treatment the risk was no longer significantly different from unexposed time. The authors suggested the excess before treatment may reflect protopathic bias or increased health care utilization, and may not be a true causal relationship.¹⁰

In a third registry study, of children and young adults, ADHD medication use was most strongly associated with undefined arrhythmias (adjusted odds ratio 2.66; 95% CI, 2.27 to 3.13), while defined arrhythmias showed no association. The authors noted that registry data left the character and clinical consequences of those undefined codes unknown.¹¹

Across ages, a 2022 meta-analysis found no statistically significant association between ADHD medication and cardiac arrest or arrhythmias (relative risk 1.60; 95% CI, 0.94 to 2.72). The authors wrote that a modest increase could not be ruled out.¹²

What to do about palpitations on ADHD medication

The Adderall XR label instructs patients to seek care immediately for exertional chest pain, unexplained fainting, or other symptoms suggestive of cardiac disease. Its Medication Guide tells patients to call their doctor or go to the nearest hospital emergency room right away for signs of heart problems such as chest pain, shortness of breath, or fainting.²

Palpitations with chest pain, fainting or shortness of breath: call 911 or go to an emergency department.
Palpitations without those symptoms: contact the prescriber, who can check pulse and blood pressure and review the dose.

No trial cited here tested a remedy for palpitations on a stimulant. In the pediatric trials, most cardiovascular effects resolved spontaneously or were handled with a dose change.⁷

Limitations of the evidence

This evidence has limitations. First, the palpitation rates come from trials lasting weeks, and the sources cited give no heart rhythm recordings during symptoms. Second, the registry findings rest on diagnosis codes, mostly unspecified, and the case-only designs give no absolute rate. Nevertheless, the adult trials agree that the average rise in heart rate is a few beats per minute and that few patients stop treatment because of cardiovascular symptoms.

A new pounding or racing heartbeat on ADHD medication warrants a call to the prescriber and a measured pulse and blood pressure. With chest pain, fainting or shortness of breath, it warrants emergency care.

Frequently asked questions

Are heart palpitations from Adderall dangerous?

In the adult Adderall XR trial, palpitation was reported by 2 to 4% of patients, more often than on placebo, and the sources cited give no heart rhythm recordings during symptoms. Palpitations with chest pain, fainting or shortness of breath are an emergency: call 911 or go to an emergency department. Otherwise, report them to the prescriber, who can check pulse and blood pressure.²

How do I stop heart palpitations from Adderall or Vyvanse?

No trial cited here tested a remedy. In pediatric trials, most cardiovascular effects resolved spontaneously or were handled with a dose change. Report palpitations to the prescriber, and any change in dose is made with the prescriber.⁷

What is a normal heart rate on Adderall or Vyvanse?

The Adderall XR and Vyvanse labels give an average rise of about 3 to 6 beats per minute for stimulants. In the adult trials that counted it, a resting heart rate above 90, the researchers' outlier threshold, was recorded in 4.2% of patients on a stimulant and 1.7% on placebo. The labels cited give no number that separates safe from unsafe, so a reading of 100 or 120 should be reviewed with the prescriber.^{2, 3, 4}

Can Ritalin or Concerta cause heart palpitations or tachycardia?

In adult trials of Concerta, a methylphenidate product, palpitations were reported by 3% of patients on medication and 1% on placebo, and tachycardia by 5% and 0%.¹

Can ADHD medication cause an arrhythmia?

A 2022 meta-analysis found no statistically significant association with cardiac arrest or arrhythmias (relative risk 1.60; 95% CI, 0.94 to 2.72), though a modest increase could not be ruled out. In a 2026 registry study of children, arrhythmia diagnoses were elevated in the 60 days before the first methylphenidate prescription (rate ratio 1.50) as well as during treatment (1.41), and the excess during treatment was no longer significant after 56 days.^{12, 10}

Chest pain, fainting, or shortness of breath during treatment needs immediate medical assessment. Call 911 or go to the nearest emergency department for severe symptoms. Medication changes are made with the prescriber.