Prolonged Amphetamine-Dextroamphetamine Use: An Unrecognized Cause of Cardiomyopathy

Adderall (amphetamine-dextroamphetamine), manufactured by Shire, Teva, and Impax Pharmaceuticals (Lexington, MA), is a commonly prescribed stimulant for attention-deficit/hyperactivity disorder (ADHD). It contains a combination of mixed amphetamine salts that enhance the activity of dopamine and norepinephrine in the brain. While generally well-tolerated, prolonged use has been associated with adverse cardiovascular effects, including cardiomyopathy. This condition, characterized by structural and functional abnormalities of the heart muscle, can manifest as left ventricular hypertrophy, dilation, or systolic dysfunction. Chronic amphetamine exposure may contribute to cardiotoxicity through mechanisms such as increased oxidative stress, sympathetic overactivity, and direct myocardial toxicity. We present a case report highlighting the progression of Adderall-induced cardiomyopathy, its clinical presentation, and diagnostic challenges. Given the increasing use of stimulant medications, early recognition of cardiovascular risks is essential to prevent irreversible cardiac remodeling and heart failure. Further research is needed to elucidate long-term outcomes and optimal management strategies for affected patients.