Children with congenital heart disease and attention deficit hyperactivity disorder (ADHD) can take stimulant medications without fear of significant cardiovascular side effects, a new study has found.
Researchers have found no increased risk for death or changes in cardiac vital signs, such as blood pressure or heart rate, for children with ADHD and severe heart conditions who take stimulant medications.
They also found that when treated with stimulant medications, patients had significant improvements in ADHD symptoms as measured by standardised rating scales.
"Children with congenital heart disease are at high risk for ADHD, but fears about cardiovascular side effects, including sudden death, limit the use of stimulant medications," said senior author Julia Anixt, a developmental and behavioural pediatrician at Cincinnati Children's Hospital Medical Centre in US.
"This study indicates that stimulants are both effective and safe when prescribed with appropriate monitoring and in collaboration with the patient's cardiologist," Anixt said.
The researchers studied 44 children between the ages of 6 and 18 seen in the Cincinnati Children's Heart Institute Kindervelt Neurodevelopmental and Educational Clinic.
They compared these patients to those with similar heart disease but who were not treated with stimulants.
The researchers' next step is to study the effect of stimulant medications on electrocardiograms (EKGs), which measure electrical activity of the heart.
Since 2006, the US Food and Drug Administration has required labelling of stimulant medications to include a warning that they generally should not be used in children and adolescents with serious structural cardiac abnormalities, cardiomyopathy or arrhythmias.
However, stimulants are the most effective medication to treat ADHD symptoms, and patient families, cardiologists, and developmental pediatricians must together weigh the risks and benefits of medication treatment options for each individual patient, according to Anixt.
