# Rethinking psychostimulant treatment for ADHD in older adults - URL: https://alisanburak.com/en/wcp-2026-posterler/so176 - Language: en - Last updated: not specified - Page title: Rethinking psychostimulant treatment for ADHD in older adults | WCP 2026 Summary > Chronological age alone is not a reason to discontinue psychostimulant treatment; the increase in cardiovascular risk at treatment initiation is transient. This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/wcp-2026-posterler/so176) This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it. SO176 Brief Oral Poster PresentationGeriatricsReview # Rethinking psychostimulant treatment for ADHD in older adults RETHINKING PSYCHOSTIMULANT TREATMENT FOR ADHD IN OLDER ADULTS Presenter: Oussama A. Latroche Country: Switzerland Institution: Geneva University Hospitals (HUG), Department of Psychiatry Session: 3030 - PARALLEL SHORT ORAL POSTER SESSIONS: GERIATRIC PSYCHIATRY 01 Date: Thu, 24.09.2026 Chronological age alone is not a reason to discontinue psychostimulant treatment; the increase in cardiovascular risk at treatment initiation is transient. This review aims to discuss the evidence on psychostimulant use for the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults over 65 and decisions about continuing or initiating treatment. A narrative review of the efficacy, tolerability, and cardiovascular (CV) safety of methylphenidate (MPH) and lisdexamfetamine was conducted, integrating evidence from observational studies, meta-analyses, and guidelines with the clinical experience of a geriatric psychiatry service. The risk of cardiovascular events increases during the first 30 days after treatment initiation (hazard ratio [HR] 1.4; 95% CI 1.1–1.8), but this increase is no longer statistically significant at 180 days (HR 1.2; 95% CI 0.9–1.6) or 365 days (HR 1.0; 95% CI 0.6–1.8). Among the studies summarized, the Liu 2019 meta-analysis (predominantly adults under 65) found no significant association with mortality, myocardial infarction, or stroke; the Michielsen 2021 study (ages 55–79) reported clinical improvement alongside slight increases in blood pressure and heart rate, with no major CV events reported; and the Paulmann 2024 study found no difference in CV risk between MPH and amphetamines. The authors emphasize that medication risk should be weighed not against zero risk but against the functional impairment associated with untreated ADHD, and that closer monitoring is needed for those over 75 or with CV comorbidities. In their own clinical decision-making framework, which is not a guideline, continuing treatment with regular reassessment of benefits and risks is considered reasonable for patients with an established diagnosis, documented functional benefit, and good treatment tolerability, particularly those aged 65–74. For patients newly diagnosed after age 65, however, treatment is not considered a first-line option and is restricted to individuals with substantial functional impairment. Practical recommendations include starting long-acting MPH at 5–10 mg/day, waiting 28 days before increasing the dose, obtaining a baseline ECG, assessing blood pressure and CV history, and conducting monthly follow-up. [View the original poster](https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1292) How to cite this study APA 7: Latroche, O. A., et al. (2026, September 24). Rethinking psychostimulant treatment for adhd in older adults [Poster presentation]. 26th WPA World Congress of Psychiatry (WCP 2026), Stockholm, Sweden. https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/1292 Vancouver: Latroche OA, et al. Rethinking psychostimulant treatment for adhd in older adults [poster]. 26th WPA World Congress of Psychiatry (WCP 2026); 2026 Sep 23-26; Stockholm, Sweden. 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