May 6, 2008–Children should have their hearts checked before starting medications for attention deficit hyperactivity disorders (ADHD), according to the American Heart Association (AHA).
The medications used to treat ADHD are stimulant medications that can get the heart rate and blood pressure racing. Between 1999 and 2004, 19 children taking ADHD medications have died suddenly. Others have had strokes, cardiac arrest and heart palpitations.
The AHA recommends children and adolescents be screened before taking medication, including getting an electro-cardiogram (ECGs). Any child already taking the medications should be tested.
“If the doctor prescribes them, the parent should know whether their child has a heart condition or not before they give the medication,” said Dr. Victoria Vetter, of the Children's Hospital of Philadelphia. ADHD medications can be used in children with heart conditions, as long as they’re carefully monitored, she said.
“(ECGs) can tell you if any of the chambers of the heart are enlarged or if there are any electrical abnormalities in the heart that might lead to an abnormal heart rhythm,” according to Vetter. The issue is that children with heart conditions who take the medicine may be at risk for sudden cardiac death.
Many times heart conditions in children are undiagnosed, said Vetter, so all children taking the medications should be checked.
“Probably as many as two percent of the population of children have heart conditions. That can put them at risk for a sudden cardiac event that can be quite serious,” Vetter said.
In addition to an ECG, doctors recommend a physical exam. “This includes taking a very through family history, asking if there are any sudden deaths under the age of 30 or 35, asking questions about personal history— have they ever fainted after exercise, do they have chest pain with exercise,” Vetter said.
The most common ADHD medications are Concerta, Ritalin, Adderall and Strattera.
“These medications are simply stimulants,” Vetter said. “Exercise can have the same effect, so we want to identify children with heart disease. That does not mean they can’t take the medication. In fact, because there is such a high prevalence of this condition in individuals who have complex heart disease and are young, we want them to be able to take the medicine. We simply want them to be able to take it safely,” Vetter said.
Vetter said the medications are very helpful in treating the disorder and said even children with heart conditions can take them safely if they are checked and monitored.
-WCAU-TV, Philadelphia, Pennsylvania