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Cited by 34Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesCardiomyopathy and Myosin Studies

Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry

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Warren, A.E., Hamilton, R.M., Bélanger, S.A., Gray, C., Gow, R.M., Sanatani, S., Côté, J-M., Lougheed, J. +7 more·2009·Canadian Journal of Cardiology
DOI 10.1016/s0828-282x(09)70157-6PMC PMC2776560
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Abstract

Regulatory decisions and scientific statements regarding the management of attention-deficit hyperactivity disorder (ADHD) raise questions about the safety of medications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or functional heart disease. The present paper reviews the available data, including peer-reviewed literature, data from the United States Food and Drug Administration Web site on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry, with specific expertise and knowledge in the areas of both ADHD and pediatric cardiology. The present statement advocates a thorough history and physical examination before starting stimulant medications, with an emphasis on the identification of risk factors for sudden death, but does not routinely recommend electrocardiographic screening or cardiac subspecialist consultation unless indicated by history or physical examination findings. A checklist for identifying children who are potentially at risk of sudden death (independent of ADHD or medications used to treat it) is provided. Although recommendations are based on the best evidence currently available, the committee further agrees that more research on this subject is necessary to optimize the approach to this common clinical scenario.

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Crossref · 10.1016/s0828-282x(09)70157-6

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  • Routine electrocardiography screening and/or cardiology investigations are needed before starting stimulant use only in those with a positive family or personal cardiac history.

    “Consensus has been reached in the USA, Canada and Europe that routine electrocardiography screening and/or cardiology investigations are needed before starting stimulant use only in those with a positive family or personal cardiac history [58,59].”

    From Advances in understanding and treating ADHD (2011) · cites this paper as [58]

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Authors
Warren, A. E., Hamilton, R. M., Bélanger, S. A., Gray, C., Gow, R. M., Sanatani, S., Côté, J.-M., Lougheed, J., LeBlanc, J., Martin, S., Miles, B., Mitchell, C., Gorman, D. A., Weiss, M., & Schachar, R.
Affiliations
  • Dalhousie University (CA)
  • University of Toronto (CA)
  • Centre Hospitalier Universitaire Sainte-Justine (CA)
  • University of Ottawa (CA)
  • University of British Columbia (CA)
  • Centre hospitalier universitaire de Québec (CA)
  • Royal University Hospital (CA)
ORCID
Venue
Canadian Journal of Cardiology
Publisher
Elsevier BV
Published
2009-11
Volume
25
Issue
11
Pages
625-630
ISSN
0828-282X (ISSN-L)
DOI
10.1016/s0828-282x(09)70157-6
PMC
PMC2776560
OpenAlex
W1997695319
Cited by
34
References
39
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2015: 4 · 2013: 2 · 2012: 6
FWCI
3.49
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Canadian Journal of Cardiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
Keywords
attention deficit hyperactivity disorder, stimulant medication, cardiac risk assessment, sudden cardiac death, pediatric cardiology, adverse drug reactions, electrocardiogram screening, children and adolescents
MeSH terms
Adolescent, Age Factors, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Canada, Cardiovascular Diseases, Child, Child, Preschool, Dose-Response Relationship, Drug, Drug Administration Schedule, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Mass Screening, Sex Factors, Death, Sudden, Cardiac, Treatment Outcome, Sickness Impact Profile, Risk Assessment

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