Stimulant medications can be associated with an increase in heart rate (1-2 beats per minute), systolic blood pressure (1-4 mmHg), and diastolic blood pressure (1-2 mmHg). Knowing these limitations, a joint statement from the AAP and AHA now recognizes that it is not a requirement to obtain an ECG prior to starting therapy, and that therapy should not be delayed before a patient undergoes an ECG evaluation (see Cortese, 2013).Ĭardiovascular effect of stimulant medications In a 2011 New England Journal of Medicine paper, there was no evidence of increased risk of severe cardiovascular events among 1,200,438 children and young adults who were taking stimulant medications (see Cooper, 2011). There is no known association between any specific congenital heart disease and sudden death related to stimulant medication. This is actually less than the reported incidence of death in the general pediatric population, which is estimated to be eight to sixty-two per 1,000,000 children (see Perrin, 2008). Interestingly, when you look at the total number of children who receive stimulant medications, the reported incidence of death is less than two per 1,000,000. Stimulant medications and severe cardiovascular events In this article, we discuss cardiovascular side effects of stimulant medications and provide a practical approach to parents and primary care physicians. On the other hand, the American Academy of Pediatrics (AAP) strongly argued against this recommendation. This led the American Heart Association (AHA) to suggest that it was reasonable for providers to obtain an electrocardiogram (ECG) prior to starting ADHD therapy. In 2006, the FDA released a warning on ADHD medications based on twenty-five reported cases of sudden death in children and adults who were taking stimulant medications. The healthcare system unfortunately has added confusion to ADHD management. Common ADHD medications & treatments for children.THE FAMILIES OF CHILDREN WITH ADHD FACE MANY CHALLENGES, including caring for those affected and dealing with the potential side effects associated with therapy. Commonly prescribed antidepressants and how they work.Īmerican Academy of Pediatrics. National Library of Medicine: MedlinePlus. Highlights of prescribing information: Tenex (guanfacine hydrochloride). Catapres-TTS (clonidine) transdermal therapeutic system. Highlights of prescribing information: Intuniv (guanfacine).įood and Drug Administration (FDA). Highlights of prescribing information: Catapres (clonidine). Highlights of prescribing information: Kapvay (clonidine). Non-stimulant medications available for ADHD treatment. Highlights of prescribing information: Qelbree (viloxazine).Īmerican Academy of Pediatrics. Highlights of Prescribing Information: Strattera (atomoxetine). Stimulant ADHD medication and risk for substance abuse. Highlights of prescribing information: Xelstrym (dextroamphetamine) transdermal system.Ĭhang Z, Lichtenstein P, Halldner L, et al. Adult attention-deficit/hyperactivity disorderdiagnosis, management, and treatment in the DSM-5 era. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Diagnosis and management of ADHD in children. What medications are used to treat ADHD?įelt BT, Biermann B, Christner JG, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Wolraich ML, Hagan JF Jr, Allan C, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Faraone SV, Banaschewski T, Coghill D, et al.
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