Cardiovascular Monitoring and Stimulant Drugs for Attention-Deficit/Hyperactivity Disorder
Abstract
A recent American Heart Association (AHA) statement1 recommended electrocardiograms (ECGs) routinely for children before they start medications to treat attention-deficit/hyperactivity disorder (ADHD). The AHA statement reflected the thoughtful work of a group committed to improving the health of children with heart disease. However, the recommendation to obtain an ECG before starting medications for treating ADHD contradicts the carefully considered and evidence-based recommendations of the American Academy of Child and Adolescent Psychiatry2 and the American Academy of Pediatrics (AAP).3,4 These organizations have concluded that sudden cardiac death (SCD) in persons taking medications for ADHD is a very rare event, occurring at rates no higher than those in the general population of children and adolescents. Both of these groups also noted the lack of any evidence that the routine use of ECG screening before beginning medication for ADHD treatment would prevent sudden death. The AHA statement pointed out the importance of detecting silent but clinically important cardiac conditions in children and adolescents, which is a goal that the AAP shares. The primary purpose of the AHA statement is to prevent cases of SCD that may be related to stimulant medications. The recommendations of the AAP and the rationale for these recommendations are the subject of this statement. This statement has been endorsed by the American Academy of Child and Adolescent Psychiatry, the Society for…
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Stimulant medications have not been shown to increase the risk of sudden death beyond that observed in children not receiving stimulants.
“In fact, stimulant medications have not been shown to increase the risk of sudden death beyond that observed in children who are not receiving stimulants.114–118”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [114]
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Cunningham, N. R., & Jensen, P. S. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-0755-7.00030-0 · Cited by 8 · see citing works
Management of a Hyperactive Teen and Cardiac Safety
Sowinski, H., & Karpawich, P. P. (2013) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2013.09.021 · Cited by 8 · see citing works
Diagnosis and management of sudden death in children
Fish, F. A., & Kannankeril, P. J. (2012) · Current Opinion in Pediatrics · doi:10.1097/mop.0b013e328357a7c3 · Cited by 8 · see citing works
Kim, H., Kim, E. J., Kim, J.-H., Park, J., Bahn, G. H., Lee, Y. J., Jhung, K., & Shin, D. (2017) · Journal of korean Academy of Child and Adolescent Psychiatry · doi:10.5765/jkacap.2017.28.2.70 · Cited by 8 · see citing works
Controversies Surrounding Pediatric Psychopharmacology
Steinberg-Epstein, R., Book, T. M., & Wigal, S. B. (2011) · Advances in Pediatrics · doi:10.1016/j.yapd.2011.03.002 · Cited by 8 · see citing works
Sudden cardiac death in a young male endurance athlete
Seely, K. D., Crockett, K. B., & Nigh, A. (2023) · Journal of Osteopathic Medicine · doi:10.1515/jom-2023-0097 · Cited by 7 · see citing works
Foisy, M., & Williams, K. J. (2011) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.731 · Cited by 7 · see citing works
Attention Deficit Hyperactivity Disorder Screening Electrocardiograms: A Community-Based Perspective
Shahani, S. A., Evans, W. N., Mayman, G. A., & Thomas, V. C. (2013) · Pediatric Cardiology · doi:10.1007/s00246-013-0810-5 · Cited by 7 · see citing works
Kardiovaskulær risikovurdering ved bruk av AD/HD-medikamenter hos barn
Berg, A., Bråtane, E., Odland, H. H., Brudvik, C. E., Rosland, B., & Hirth, A. (2014) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.13.0565 · Cited by 7 · see citing works
Cardiovascular safety of medication treatments for attention‐deficit/hyperactivity disorder
Newcorn, J. H., & Donnelly, C. L. (2009) · Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine · doi:10.1002/msj.20096 · Cited by 7 · see citing works
Chen, C., Bussing, R., Hartzema, A. G., Shuster, J. J., Segal, R., & Winterstein, A. G. (2015) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3894 · Cited by 7 · see citing works
- Authors
- Perrin, J. M., Friedman, R. A., Knilans, T. K., the Black Box Working Group, & Surgery, T. S. O. C. A. C.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-08-01
- Volume
- 122
- Issue
- 2
- Pages
- 451-453
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2122369545
- Cited by
- 161
- References
- 16
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 4 · 2016: 11 · 2015: 9 · 2014: 10 · 2013: 7 · 2012: 25
- FWCI
- 15.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- 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 › Cardiac electrophysiology and arrhythmias
- Keywords
- attention deficit hyperactivity disorder, stimulant medication, sudden cardiac death, electrocardiogram screening, cardiovascular monitoring, American Heart Association guidelines, American Academy of Child and Adolescent Psychiatry, children and adolescents
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Cardiovascular Diseases, Child, Child, Preschool, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Monitoring, Physiologic, Policy Making, Societies, Medical, Death, Sudden, Cardiac, Practice Guidelines as Topic, Risk Assessment
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