Considering ADHD meds? Have a Heart Check First

A new statement from the American Heart Association is quite explicit: Before you give kids stimulant meds for ADHD, make sure their heart health is checked. This may include an electrocardiogram (ECG).

Three things you need to know:

1. There's no new horror story behind this--though there is a rare risk of sudden cardiac death for kids with an undiagnosed heart condition given stimulants. The statement is a formalization of what's previously been known and recommended as early as 1999. Earlier statements included stimulants on a list of other drugs where heart checks were recommended. This one singles out stimulants.

2. From a statement author: "After ADHD is diagnosed, but before therapy with a stimulant or other medication is begun, we suggest that an ECG be added to the pre-treatment evaluation to increase the likelihood of identifying cardiac conditions that may place the child at risk for sudden death."

3. The true risk isn't known, but about 2.5 million kids were taking stimulant meds in 2003. Between 1999 and 2004, 19 children died of sudden cardiac death linked to the pills; 26 had other significant heart episodes.

So: Take this seriously, and reveal any suspicions, family history or past heart-related  episodes to your pediatrician or psychiatrist before putting a child on stimulant meds. Not all kids will require comprehensive heart checks and continued monitoring--only a small group of children is considered vulnerable.

And remember: Meds are not the only treatment. Be sure to investigate options for treating ADHD that do not include drugs.

More:

• Annoyingly, the AHA is not making the statement freely available.
• A news story on our site provides details the AHA/ADHD statement.
• Drugs included among stimulants: Adderall, Concerta, Dexedrine, Focalin, Ritalin, Ritalin SR or LA, and Metadate ER or CD. Also included is the non-stimulant ADHD drug Strattera. See our page on ADHD drugs for details on these meds and their side effects.