ADHD Stimulant Medication and ER Visits
ADHD Stimulant Medication and ER Visits for Heart Problems in Children
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? The University of Florida researched this question and published their results in the journal Pediatrics in December, 2007.
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 rare.
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 the 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. In other words, for every 100 children or teens who have to go to the ER or doctor's office for scary heart symptoms, there are 120 children or teens who take stimulant medication who have to go to the ER.
However, rates of death or admissions to a hospital were no different that the rates among those not being treated with stimulant medications.
ADHD Medication and FDA Warnings
There is an ongoing controversy within various committees in the FDA about whether stimulant medications should carry a “black box” warning label. In 2006 the FDA added the “black box” warning to the labels of ADHD medications warning of possible heart risks from 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 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 noted 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.