Cardiac Screening Recommended for Kids Taking Stimulants for ADHD

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Some of the names under which these drugs are marketed include Adderall, Concerta, Dexedrine, Focalin, Ritalin, Ritalin SR or LA, and Metadate ER or CD. The new recommendations refer to all of these stimulants, as well as to a newer drug known as Strattera, which was recently approved by the U.S. Food and Drug Administration as a non-stimulant treatment for ADHD.

Though ADHD stimulants increase a child's heart rate and blood pressure, the NIH noted that no evidence has indicated that such medications are addictive, and side effects do not typically pose any danger for most healthy children.

However, children with underlying heart disease who take stimulants for ADHD appear to face an increased risk for sudden cardiac arrest, the AHA noted. This risk association is particularly troublesome for young ADHD patients, because heart disease often goes undiagnosed in children and may be present without noticeable symptoms.

The AHA also pointed to a number of studies that suggest that between 33 percent and 42 percent of pediatric heart patients also have ADHD.

FDA data collected for the period 1999 through 2004 revealed that 19 children following an ADHD prescription regimen had died suddenly, while 26 experienced heart complications such as stroke, heart attack, and/or heart palpitations.

Vetter noted that, in 2005, the Canadian equivalent of the FDA -- Health Canada -- decided to place a ban on Adderall, an amphetamine-based ADHD medication designed for kids over the age of 3. The Canadian decision was actually based on a review of FDA records concerning 12 reported deaths among American children taking ADHD drugs.

Vetter pointed out that the Canadian decision was based on an assessment of collected data based on family self-reports (sometimes in the absence of autopsy records), rather than a complete scientific analysis.

"But the reality is that we were faced with some kids who had ADHD who suddenly died," she said. "And a lot of them were exercising at the time, which is when most of the kids who have electrical malfunctions of the heart would have a sudden cardiac death. So we have to assume they experienced a cardiac death."