November 07, 2011
Andrew Adesman, MD
Stimulant medications are generally viewed as the safest and most effective medications for the treatment of attention deficit hyperactivity disorder (ADHD). Several years ago, concerns were raised about the possibility of a small but increased risk of sudden cardiac death among children and adolescents treated with stimulant medication for ADHD. Although subsequent analyses suggested that there is no increased risk, patients and clinicians have remained cautious about these medications from a cardiac standpoint.
In this week’s New England Journal of Medicine, a team of researchers present findings from their analysis of an extraordinarily large sample (1.2 million children and young adults) with respect to ADHD drugs and serious cardiovascular events. This new study once again fails to find an association between treatment with stimulant medication and sudden cardiac death, myocardial infarction or stroke. Although the authors acknowledge that they cannot rule out a modest increase in risk, the data are overall quite reassuring, especially considering that they did not exclude children with congenital heart disease--a group presumed to be at increased cardiovascular risk--from the analyses.