Carry Black
Are the risks of heart problems greater in children who are prescribed stimulant medications for ADHD than for children who are not taking such medications? Researchers from the University of Florida looked into this question, and what they found may make some parents uneasy.
The researchers looked at the records of over 50,000 children and teenagers who had ADHD, and were treated with stimulants such as Ritalin and other Methylphenidate compounds, Dexedrine, and Adderall. Then they compared the findings from this group to a database of over 2 million children and teenagers to see if there were any differences.
What they found was that the use of stimulant medication for ADHD in children and teenagers may be the cause for an increased number of emergency room visits, or visits to the doctor’s office, because of cardiac symptoms such as a racing heart or increased blood pressure. But the study also found that deaths, or serious heart complications, are as rare as in the general population.
They found that children and teenagers treated with stimulants for ADHD were about 20 percent more likely to have to go to a doctor’s office or emergency room with cardiac symptoms than children and teens that were not taking stimulant medications. However, rates of death or admissions to a hospital were no different that the rates among those not being treated with stimulant medications. Their results were published in the journal Pediatrics in December, 2007.
There has been an ongoing controversy within various committees in the FDA about whether stimulant medications should carry a “black box” warning label. The Drug Safety and Risk Management Advisory Committee had voted 8 to 7 for the label warning, but the Pediatric Advisory Committee did not believe it was warranted. The Pediatric Advisory Committee concluded that, “Potential episodes of psychosis, aggression and cardiac events with attention deficit drugs in children do not warrant a black box warning.” This committee felt that the cardiovascular events were not of a similar risk in ADHD children as adults, except for those with cardiovascular abnormalities. The committee also declined to endorse a black box label for psychiatric events, including aggression, and risk of suicide,
But, after much debate, the FDA added the “black box” warning to the labels of ADHD medications warning of possible heart risks from the medications. These are the strongest warnings that the FDA requires, a step away from pulling the medications. The warnings on the label included possible sudden death in patients who have heart problems or heart defects, stroke and heart attack in adults, and increased heart rates and increased blood pressure.
The authors of this new study note that they do not know the long-term implications of increased heart rate and blood pressure in children and teens treated with stimulant medications. They also reported that about 25 percent of children and teens treated with stimulants were also prescribed either an antidepressant medication or an antipsychotic medication, which can also impact the heart and blood pressure.
Learn about ADHD and treatment for attention deficit hyperactivity disorder at http://NewIdeas.net, or for 500 ADHD classroom interventions visit ADDinSchool.com. This information is not to be considered medical advice, but is for information only. Consult your physician.
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