Q. My son has been diagnosed with ADHD. What do I need to know about his medication and its effects on his heart?
A. Stimulant medications such as Ritalin, Adderall, Concerta and Focalin have been effective at treating attention deficit hyperactivity disorder (ADHD) for decades. According to the FDA, an estimated 2.5 million children and teenagers in the United States are currently being treated with these medicines.
Recently, concerns have been raised about the use of these medications in children and the development of heart disease and risk of sudden cardiac death. This was based on Canada’s ban of the sale of Adderall XR in 2005, which was reversed six months later, as well as the requirement by the FDA that all stimulant medications carry a “Black Box Warning” regarding possible side effects for those patients with cardiovascular disease.
The truth is that there have been no established links between the use of stimulant medications and sudden cardiac death in children, and stimulant medications do not cause heart disease in children.
Prior to starting any stimulant medication, your primary care physician should review your child’s medical history and family history to rule out any previously diagnosed or potential cardiac conditions. Special care must be taken for children with pre-existing heart disease, as they may be at an increased risk for side effects and interference with cardiac medications. Only after these issues have been addressed should a child be cleared to start medication.
Steven Herold, M.D., FAAP
Division of Pediatric Cardiology
T.C. Thompson Children’s Hospital at Erlanger
910 Blackford Street
Chattanooga, TN 37403
Ph. (423) 778-6180