X: Study from the Univ of Florida about heart risks of stimulants in children with ADHD

December 03, 2007
Study from the Univ of Florida about heart risks of stimulants in children with ADHD


There. I can pinpoint Ritalin as one of the factors in my high blood pressure.

UF study examines heart risks of stimulants in children with ADHD
GAINESVILLE, Fla. — Stimulant medications used to treat children with attention-deficit hyperactivity disorder may be responsible for an increased number of visits to the emergency room or doctor’s office because of cardiac symptoms, but deaths or serious heart complications are rare, a new University of Florida study reveals.
“Treatment decisions are always a risk-benefit assessment for doctors,” said Almut Winterstein, an assistant professor of pharmacy health care administration at the University of Florida’s College of Pharmacy. “We know about the benefits of central nervous system stimulants. There are a lot of advantages to the patient — improved concentration, the improved ability to interact socially — but the risks have been very poorly defined.”

Despite concerns about the risks of taking medications such as Adderall and Ritalin for the treatment of ADHD — the drugs are known to raise blood pressure and heart rate, and other members of this drug class, such as methamphetamine, are associated with serious adverse effects — use of the drugs has steadily risen over the past decade.
Winterstein, a pharmacoepidemiologist, led a team of researchers in pharmacy, pediatric medicine and psychiatry who analyzed records from 55,000 children ages 3 to 20 who had ADHD and were undergoing treatment between 1994 to 2004. The UF study, which sought to assess the effects of these drugs on the risk for heart disease, relied on the Florida Medicaid database of more than 2 million youth, cross-matched with vital statistics records — the first of this magnitude in ADHD safety research.

The researchers published their findings Dec. 1 in the journal Pediatrics.
Children who used central nervous system stimulants were 20 percent more likely to visit an emergency clinic or doctor’s office with cardiac-related symptoms, such as a racing heartbeat, than children who had never used or discontinued treatment. The researchers also reported that the rates of death or hospital admission for serious heart conditions were no different than the national rates among the general population, but the total number of events was too small to allow definite conclusions.

Since 1995, the number of patients newly diagnosed with ADHD has grown at a fairly constant rate, Winterstein said. Today, nearly one-third of these patients — more than 5 percent of American children — chronically take stimulant medications.
Approximately 3 million to 4 million youngsters in the U.S. are prescribed stimulant medications for ADHD, said Dr. Daniel Safer, an associate professor in psychiatry and pediatrics at Johns Hopkins University School of Medicine.
Safer added that the major side effects from stimulant treatment are decreased appetite and, in some cases, difficulty falling asleep.
“Methylphenidate and dextroamphetamine have been carefully studied for cardiovascular side effects in children for periods up to three years in extended clinical trials, and the reports indicate minor blood pressure and heart rate changes — which the authors deem clinically insignificant,” Safer said
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