Cardiac Screening Recommended for Kids Taking Stimulants for ADHD

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By Alan Mozes
HealthDay Reporter
Monday, April 21, 2008; 12:00 AM

MONDAY, April 21 (HealthDay News) -- The American Heart Association on Monday issued recommendations that call for cardiovascular screening before prescribing stimulant treatment for all children diagnosed with attention-deficit hyperactivity disorder (ADHD).

The guidelines are meant to address mounting fears that these medications can raise the risk for cardiac complications among those with underlying heart disease.

"This is new, and it is a shift in our policy," said Dr. Victoria L. Vetter, head of the association's statement writing committee, and a professor of pediatrics at the University of Pennsylvania School of Medicine in Philadelphia.

"But we're not recommending that every child in the country have these heart screenings, rather that they be used as a reasonable tool for this small, particular group of children about to take ADHD medications, so we can ensure the treatment proceeds as safely as possible," she added.

The recommendations were published online Monday inCirculation, a journal of the American Heart Association (AHA).

They include: the taking of a detailed patient and family medical history, particularly regarding heart disease; a full physical exam, including blood pressure and heart beat monitoring; an electrocardiogram (ECG); and a pediatric cardiologist consultation prior to treatment if evidence of heart disease is uncovered.

After treatment begins, the AHA said that children should continue to have blood pressure check-ups once every one to three months, as well as routine health check-ups every six to twelve months.

The AHA noted that ADHD is the most common neurobehavioral disorder among American kids, with estimates indicating that between 4 percent and 12 percent of American school-aged children have the condition.

Currently, more than 2.5 million children in the United States are being prescribed ADHD medications, the organization noted.

According to the U.S. National Institutes of Health (NIH), the most effective ADHD medications typically belong to the "stimulant" class of drugs, which includes amphetamines, methylphenidates and dextroamphetamines.

Some of the names under which these drugs are marketed include Adderall, Concerta, Dexedrine, Focalin, Ritalin, Ritalin SR or LA, and Metadate ER or CD. The new recommendations refer to all of these stimulants, as well as to a newer drug known as Strattera, which was recently approved by the U.S. Food and Drug Administration as a non-stimulant treatment for ADHD.

Though ADHD stimulants increase a child's heart rate and blood pressure, the NIH noted that no evidence has indicated that such medications are addictive, and side effects do not typically pose any danger for most healthy children.

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