Researchers from Columbia University and the New York State Psychiatric Institute investigated the potential hazards of taking stimulants for ADHD.
Study of sudden unexplained deaths
They examined death statistics from 1985-1996 and compared 564 cases of young people who had suffered sudden unexplained death, between the ages of seven to 19, with those of 564 killed in car accidents.
Researchers excluded subjects with heart abnormalities or a family history of sudden unexplained death. They interviewed parents and examined autopsy reports to determine whether the victim had a heart abnormality or had been taking an ADHD stimulant drug.
Study findings
They observed that 10 or 1.8 percent of those who had died suddenly for no apparent reason had been taking stimulant medication at the time, while only two or 0.4 percent of the children who died in vehicle crashes were on the same medication.
The researchers found that compared to children killed in auto accidents and not taking the drugs, kids on the ADHD drugs were 7.4 times more likely to die suddenly.
Scientists said the link between stimulant drugs and heart-related death may be because the drugs increase blood pressure and change heart rates. Experts believe it is possible that stimulants may aggravate hidden, underlying heart disorders.
But scientists also wanted the parents to keep in mind that only a few children each year experienced unexplained sudden death, and only a tiny percentage of these had a link to stimulants.
Assessment of heart risk important
Lead researcher Madelyn S. Gould stated that although the study does not prove that ADHD stimulants cause cardiac deaths, it highlight the importance of carefully screening children and teens for heart conditions when the medications are prescribed.
“These are very rare events, and parents should not be overly concerned,” she says. “This shouldn’t stop anyone from using medications that can help children. But the clinicians who prescribe these drugs must be vigilant about screening and monitoring their patients.”
FDA’s cautions
The U.S. Food and Drug Administration (FDA), which funded the research with the National Institutes of Health, said the study had “limitations”.
In a cautionary statement, the FDA recommends parents tell doctors if there have been cases of sudden, unexplained deaths in the family. They also propose discussing the risks and benefits of stimulants with the physician, both before treatment and periodically, to ensure proper treatment.
ADHD drugs carry the FDA’s strongest warning about sudden death and cardiac risks, but doctors should still assess patients for heart risks when prescribing drugs.
The FDA is now conducting two studies, both in children and adults whose use of ADHD medications has been increasing, to see whether the drugs are linked with a higher risk of sudden death, heart attack or stroke.
The results of the study were published in the American Journal of Psychiatry.
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