Little evidence of heart risks with ADHD drugs

Little evidence of heart risks with ADHD drugs

Drugs commonly used to treat attention deficit disorder does not appear to increase the risk of heart attack and other cardiovascular problems in children and young adults, new research shows.

And if the risk is increased by stimulants such as Ritalin, Adderall and Concerta is that the risk is very low in absolute terms, said Dr. William O. Cooper, author of a study published online Nov. 1 in the New England Journal of Medicine.

"It is the largest study to date, and I think it provides reassuring information on the risk," said Cooper, professor of pediatrics and preventive medicine at Vanderbilt University in Nashville, Tennessee

Another expert agreed. "This information is very good, not because a few years ago when we had the media tells us that we should be out of the use of these drugs with caution, we had a very good guidelines on which patients should avoid drugs, "said Dr. John Pliska, an assistant professor of pediatrics at the University of Texas A & M Health Science Center College of Medicine and head of children's cardiologist, Scott & White in Temple, Texas.

Nearly 3 million children in the attention in the U.S. snuff (ADHD) in each year. Children with this disorder is excessive neuronal activity, inattention and impulsivity.

For a typical child is diagnosed with the disease, "if ADHD medications seem to be an important part of treatment, attention to risk of cardiovascular events would surely be less," added Cooper. "That said, it's really important that every child should be evaluated with your health care provider to decide whether it makes sense."

Several years ago, some cases of sudden death, heart attack and stroke among users were worried about their parents and health professionals about the safety of these drugs are prescribed to help children to focus and control their behavior.

Canadian health officials of some of Adderall on the market in 2005, and the U. S. Food and Drug Administration (FDA) requested that ADHD drugs carry "black box" warnings, and guidance to patients.

Then, the American Heart Association said it was "reasonable" given to children in addition to monitoring ECG before stimulant medication.

"It really increased the anxiety and confusion for families and health professionals," said Cooper.

You can try to solve the problem, Cooper and his colleagues analyzed data 1200000 children and young adults aged 2-24 enrolled in four large health plans across the United States. This is called a meta-analysis.

"We compared the current use of medication for ADHD for those who use these drugs to investigate an attack of sudden cardiac death and stroke," said Cooper. These drugs are methylphenidate (Ritalin, Concerta), dexmethylphenidate (Focalin), dextroamphetamine (Dexedrine), amphetamine salts (Adderall), atomoxetine (Strattera), and pemoline (Cylert).

The authors concluded that there was really no risk for heart problems with these drugs, but also recognized the possibility of a risk of 85 percent greater.

This is due to the large size of the study and the rarity of events was difficult to monitor their risk increases.

"Saving the environment, even if it was a doubling of the absolute risk is very, very small," said Cooper.

The results are similar to several articles published by the safety review by the FDA is over, according to the authors.

For his part, said Pliska EKGs [ECG], it might be useful to define some of the children with heart defects.

And Cooper agreed that some children may have an underlying heart disease or other problems that may put them at risk. "We need to think about the risks of the individual," he said, "but at the population level, this [study] shows that the risk does not increase."

Dr. Howard S. Weintraub, clinical director of the Center for Cardiovascular Disease Prevention NYU Langone Medical Center in New York, it was agreed that information should address concerns about the safety of the drug. "

The results show that "when these drugs are used appropriately and correctly considered young, do not increase the risk," says Weintraub.

"This is a comprehensive study that examines the lives of many young children," he said. "The only problem is that the Medicaid population has been based so it might be a little different" from what we've had some others, but if what is expected to be at higher risk. "

Although the mandate of the global test ECG in children receiving stimulant medication for ADHD, which "has not yet been considered risk factors such as family history of unexplained sudden death, cardiac history of seizures unexplained child or congenital heart disease, "said Dr. Andrew Adesman, chief of pediatrics and behavioral development, medical center and children, Alexandra, Steven Cohen in New York New Hyde Park.

He added that the new research ", we hope, more certainty for parents and professionals that stimulant medication does not pose a significant risk of cardiovascular disease."

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