Cardiovascular Events and Death in Children Exposed and Unexposed to ADHD Agents
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Objective The objective of this study was to compare the rate of severe cardiovascular events and death in children who use attention-deficit/hyperactivity disorder (ADHD) medications versus nonusers. Patients and methods We performed a large cohort study using data from 2 administrative databases. All children aged 3 to 17 years with a prescription for an amphetamine, atomoxetine, or methylphenidate were included and matched with up to 4 nonusers on the basis of data source, gender, state, and age. Cardiovascular events were validated using medical records. Proportional hazards regression was used to calculated hazard ratios. Results We identified 241 417 incident users (primary cohort). No statistically significant difference between incident users and nonusers was observed in the rate of validated sudden death or ventricular arrhythmia (hazard ratio: 1.60 [95% confidence interval (CI): 0.19-13.60]) or all-cause death (hazard ratio: 0.76 [95% CI: 0.52-1.12]). None of the strokes identified during exposed time to ADHD medications were validated. No myocardial infarctions were identified in ADHD medication users. No statistically significant difference between prevalent users and nonusers (secondary cohort) was observed (hazard ratios for validated sudden death or ventricular arrhythmia: 1.43 [95% CI: 0.31-6.61]; stroke: 0.89 [95% CI: 0.11-7.11]; stroke/myocardial infarction: 0.72 [95% CI: 0.09-5.57]; and all-cause death: 0.77 [95% CI: 0.56-1.07). Conclusions The rate of card…
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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 [118]
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- Authors
- Schelleman, H., Bilker, W. B., Strom, B. L., Kimmel, S. E., Newcomb, C., Guevara, J. P., Daniel, G. W., Cziraky, M. J., & Hennessy, S.
- Affiliations
- University of Pennsylvania (US)
- Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology,
- Carelon Research (United States) (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2011-06-01
- Volume
- 127
- Issue
- 6
- Pages
- 1102-1110
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3387871
- OpenAlex
- W2027058607
- Cited by
- 159
- References
- 26
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 9 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 15 · 2015: 12 · 2014: 18 · 2013: 17 · 2012: 31
- FWCI
- 17.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2kl2rr024132-06)
- National Center for Research Resources (KL2-RR024132, 5KL2RR024132)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- attention-deficit/hyperactivity disorder medication, cardiovascular events, sudden death, ventricular arrhythmias, stroke, myocardial infarction, all-cause mortality, amphetamine, atomoxetine, methylphenidate, children, drug safety
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Cardiovascular Diseases, Cardiovascular System, Cause of Death, Child, Child, Preschool, Female, Humans, Male, Risk Factors, United States, Incidence
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