Stimulants for ADHD may cause mild heart symptoms

Stimulants for ADHD may cause mild heart symptoms
NEW YORK (Reuters Health) - The use of stimulants bychildren and teenagers with attention-deficit/hyperactivitydisorder (ADHD) may be to blame for an increased number ofvisits to the emergency room or doctor's office because ofheart-related symptoms, but deaths or serious heartcomplications are rare, according to a study from Florida.
ADHD drugs, like Adderall and Ritalin, are known to raiseblood pressure and heart rate.
In 2006, the US Food and Drug Administration's Drug SafetyAdvisory Committee recommended "black-box" warnings -- thestrongest given by the FDA -- about cardiovascular risksassociated with stimulants used to treat ADHD. However, theFDA's Pediatric Advisory Committee disagreed, suggesting thatsuch a warning is not warranted, based on the drugs'effectiveness and the weak evidence of harm.
Formal studies looking at the risks "are overdue in lightof the scarce long-term safety data, the growing prevalence ofstimulant use, and the anecdotal evidence of serious adverseevents," Dr. Almut G. Winterstein and colleagues write in thejournal Pediatrics this month.
They analyzed data on 55,383 Florida children ages 3 to 20years who had ADHD. About 59 percent were taking a stimulantmedication during the study period (1994 to 2004).
Children who used central nervous system stimulants were 20percent more likely to visit an emergency clinic or doctor'soffice with heart-related symptoms, such as a racing heartbeat,than children who had never used or discontinued treatment, theteam found.
However, rates of death or hospital admission for seriousheart conditions were no different than the national ratesamong the general population.
Given that 3 to 4 million youngsters take stimulantmedications to control symptoms of ADHD, Winterstein's groupthinks large "forward-looking" studies with long-term follow-upare needed to determine the consequences of chronic stimulantuse during childhood on heart disease in adulthood.
SOURCE: Pediatrics, December 2007.