“The concern is that there is the possibility of sudden cardiac death, although it’s not well-established whether it’s related to the medication or not. But certainly those children who have a history of structural cardiac abnormalities should not be taking this medication.”
– Dr. Richard Winer, M.D., psychiatrist
Approximately 2.5 million American children are on stimulant medication for Attention Deficit Disorder (ADD/ADHD) -- medication that, according to the Food and Drug Administration (FDA), could potentially trigger heart problems. That’s why the American Heart Association has a new recommendation.
Devon, 17, takes the prescription medicine Adderall because she has ADHD -- Attention Deficit Hyperactivity Disorder.
Devon also has a defective valve in her heart.
“I don’t know if my heart condition is going to change or get more serious,” says Devon.
Her mother has the same fear.
“I’ve lived with this all the time, wondering secretly what this medicine was really doing to my child,” says Colleen Baird, Devon’s mother.
Is there a link between ADHD medications and heart problems?
Recent studies show that children on stimulant medication are 20 percent more likely to visit the ER for heart-related problems than kids not on these medications. That’s why the American Heart Association is recommending that every child have an EKG (electrocardiogram) prior to taking stimulants.
“The concern is that there is the possibility of sudden cardiac death, although it’s not well-established whether it’s related to the medication or not. But certainly those children who have a history of structural cardiac abnormalities should not be taking this medication,” says Dr. Richard Winer, M.D., psychiatrist.
Experts agree that any child on medication should be closely monitored by a physician. Experts also say that not all ADHD kids should be taking medication and that there are other treatments. According to Winer, however, medication increases the odds of success.
“There’s always the possibility that a child might be able to function at a decent level using non-pharmacological approaches … but the odds are certainly much greater in favor of a child who actually does utilize medication as long as they’re physically able to do so,” says Winer.
Devon’s mom says it’s a painful dilemma: the medicine helps Devon’s functionality and grades in school, but it may also be damaging her heart.
On the other hand, says her mother, “If she wasn’t on her medication, I’d also live with the other fears, the impulsivity – driving in a car, getting in an accident … doing something that is just as dangerous for her.”
Tips for Parents
Although medication is not the only way to treat Attention Deficit Hyperactivity Disorder (ADHD), the American Academy of Child and Adolescent Psychiatry (AACAP) says research clearly demonstrates that it can be helpful. Stimulant medication can “improve attention, focus, goal directed behavior and organizational skills.”
Other treatment may include cognitive-behavioral therapy, social skills training, parent education and modifications to the child’s educational program. The AACAP says a child who is diagnosed with ADHD and treated appropriately “can have a productive and successful life.”
ADHD occurs in an estimated 3-5 percent of school-age children, beginning before age 7 and sometimes continuing into adulthood. ADHD runs in families with about 25 percent of biological parents also having the disorder. According to the AACAP, a child with ADHD often shows some of the following symptoms:
Trouble paying attention
Inattention to details and makes careless mistakes
Easily distracted
Loses school supplies, forgets to turn in homework
Trouble finishing class work and homework
Trouble listening
Trouble following multiple adult commands
Blurts out answers
Impatience
Fidgets or squirms
Leaves seat and runs about or climbs excessively
Seems "on the go"
Talks too much and has difficulty playing quietly
Interrupts or intrudes on others
The FDA recommends that parents ask the following questions before selecting medication as the best treatment for their child's ADHD:
Will this drug cause a problem with other drugs my child is taking?
Will t his drug affect any other conditions my child has?
How often does my child need to take this medicine?
How many days or weeks does my child need to take this medicine?
What if I miss giving my child a dose of the medication?
How soon will the drug start working?
What side effects does the medicine have?
What should I do if my child begins experiencing any of these side effects?
Should I stop giving my child the medication when my child's behavior starts to improve?
References
American Academy of Child and Adolescent Psychiatry
National Parent Information Network
