Safety of stimulant treatment in attention deficit hyperactivity disorder: part II.
BACKGROUND
Attention deficit hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder and in at least 50% of cases persists into adulthood. Treatment of ADHD with stimulants is one of the oldest and most effective pharmacological treatments in psychiatry. Yet, there continues to be controversy over the safety of stimulant medications in the treatment of ADHD.


METHODS
This paper is a continuation of an earlier paper that reviewed the safety profile of newer stimulant agents, especially in relation to special populations. This part II reviews, through essentially an organ-system approach, the various clinical concerns that have been raised over the safety of stimulant medications. This includes neuropsychiatric, cardiovascular effects on growth and development, and a number of other less common concerns.


RESULTS
A thorough review of safety concerns in stimulants that emphasizes clinical information, case reports, open series or controlled trials relating to stimulant use in the treatment of ADHD.


CONCLUSIONS
While many safety concerns have been raised in the use of stimulants, the vast majority of treatment complications are either quickly reversible or easily manageable with appropriate clinical care. The negative consequences of untreated ADHD clearly outweigh the risks of the stimulant medicines when used in an appropriate and careful manner.
Merkel
Richard Lawrence
RL
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22908, USA. RLM3U@hscmail.mcc.virginia.edu
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000150:complications; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000378:metabolism; D005260:Female; D048788:Growth and Development / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D011247:Pregnancy; D012449:Safety
D000697:Central Nervous System Stimulants