Attention-deficit/hyperactivity disorder, stimulant therapy, and the patient with congenital heart disease: evidence and reason.
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood, and congenital heart disease (CHD) is the most common form of birth defect. Children with CHD are at increased risk for neurodevelopmental disorders such as ADHD. Stimulant medications, specifically methylphenidates and amphetamines, are frequently prescribed and effective in reducing the symptoms of ADHD. Despite their efficacy and long history of use, the safety of these medications has recently come into question due to isolated reports describing sudden unexplained death of children undergoing treatment. This review summarizes the current literature on the cardiovascular risks associated with the use of pharmacologic therapy for ADHD, with an emphasis on patients who had CHD.
Division of Pediatric Cardiology, Children’s Hospital of Orange County, University of California at Irvine, 455 S Main Street, Orange, CA 92868, USA. abatra@uci.edu
Anjan S
AS
Batra
Mark E
ME
Alexander
Michael J
MJ
Silka
D000662:Amphetamines / Q000009:adverse effects / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D003324:Coronary Artery Disease; D016757:Death, Sudden, Cardiac; D019317:Evidence-Based Medicine; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
D000662:Amphetamines; D000697:Central Nervous System Stimulants; D008774:Methylphenidate