Woman left with failing heart after years of nonprescribed ADHD stimulant use, now awaiting transplant

A New Jersey woman who took prescription stimulants without a medical diagnosis for attention-deficit hyperactivity disorder (ADHD) says years of misuse left her with severe, irreversible heart damage and reliant on mechanical support while she waits for a transplant.

Mandi Masterpole, 34, told reporters she began taking drugs such as Adderall and Ritalin at about 17 to stay awake, concentrate on schoolwork and work extra jobs. She said the pills initially gave her a euphoric surge of energy that quickly escalated into daily abuse, including crushing and snorting the medication multiple times a day. "It got to the point where I would make a schedule," she said. "I would stop the pills on Tuesday, because I was off work on Wednesday… I needed to take a day to eat because I wasn't eating anything."

Masterpole said she developed severe cardiac problems by her early 20s. While she has also lived with Type 1 diabetes and acknowledged intermittent lapses in insulin use, she and treating physicians attribute substantial heart damage to years of stimulant misuse. She described an experience in labor when doctors told her she had "blown out my heart." Following childbirth, Masterpole said her heart stopped twice during a hospital stay and surgeons implanted a left ventricular assist device (LVAD) to take over the work of her weakened left ventricle. She later received a pacemaker and implantable cardioverter-defibrillator.

The LVAD is a mechanical pump that helps circulate blood when the heart's main pumping chamber is too weak. Masterpole said the devices have kept her alive but have also limited her life. She often uses a wheelchair because of fatigue and shortness of breath, has been forced to abandon mortuary school, and was counseled that future pregnancies would pose unacceptable risk. She is on a waiting list for a heart transplant but remains low on the list because the LVAD and other devices continue to provide some functional support.

Masterpole described the stimulants as initially transformative: "I remember my eyes lighting up, the colors seemed to be brighter… I thought it was like heaven. I was like, 'Oh my god, this is amazing.'" What began as a single pill a day, she said, became multiple doses, and eventually frequent snorting. Her weight fell from about 140 pounds to roughly 114 pounds as the drugs suppressed her appetite.

Medically, stimulant medications approved for ADHD, including formulations of amphetamines and methylphenidate, increase levels of neurotransmitters such as dopamine and norepinephrine to improve attention and reduce impulsivity in people with the disorder. Physicians caution, however, that when taken in high doses or without medical supervision, these drugs can raise heart rate and blood pressure, constrict blood vessels, reduce oxygen delivery to the heart and disrupt normal cardiac electrical activity, potentially leading to arrhythmias, heart muscle damage and, in rare cases, sudden cardiac arrest.

Masterpole said she continued working and caring for children while using the drugs and believed she was functioning normally: "It's not like I'm nodding off in class, it's not like I can't see the kids. I'm washing them, I'm changing diapers, I'm doing everything I need to do," she said. That perceived productivity, she said, masked the harm being done to her body.

Medical and public-health experts have warned about the risks of nonprescribed use of stimulant medications, particularly among adolescents and young adults who obtain them through diversion, online markets or from peers. In lawful medical use, stimulant prescriptions typically involve evaluation, diagnosis, dosing oversight and monitoring for cardiovascular risk factors. The medications are classified under federal law as Schedule II controlled substances because of their potential for abuse and dependence.

Masterpole said she stopped using the drugs after her cardiac events and now speaks publicly to warn others about the potential consequences. "I would tell people to steer clear of these drugs completely. It's not worth it. It may make you feel good but it's going to tear everything apart," she said.

Her case illustrates the dangers clinicians say can follow misuse of stimulant medications and underscores the importance of medical oversight for ADHD treatment, screening for cardiovascular risk, and attention to coexisting conditions such as diabetes. Masterpole remains on the transplant waiting list and receives ongoing care while physicians monitor her device-supported cardiac function.

"Here I am telling myself I'm doing the right thing getting school done but I was blowing my heart out the whole time," she said, reflecting on the years before her cardiac collapse. "It's not the quick fix I thought it was. Everybody should know it's not what you think, it will lead you down a way that you do not want to go."