February 20, 2012

ADHD, attention deficit hyperactivity disorder, is real and becoming more prevalent with every passing year. The causes are myriad, but suffice it to say that the data is pointing towards an in utero insult (occuring during pregnancy). I think that we will find that chemicals and poor quality maternal diets are turning on the cassette of genes responsible for inattention and dysfunctional executive brain functions.

At Salisbury Pediatrics, we focus on all possible avenues to treat these disorders without defaulting to medicine use. However, at times medicine seems to be the only effective avenue. For those who are taking medicine, here is some good news.

In the past 5 years there has been a flurry of concern regarding heart problems in people taking ADHD medicines. To allay these fears we have a study by Cooper et al. in the New England J Medicine 2011, showing data that children taking ADHD medicines do not have an increase risk of adverse cardiac events. They followed people for the equivalent of 2.5 million person years and found that the rate of serious heart complications was 3.1/100,000 person years.

This rate is the same as the general population not taking these medicines.

This data does not rule out subgroups that could be more sensitive to the medicines. The prudent thing to do, if you or your child is taking these medicines, is to get a full physical exam with a cardiac evaluation. If you have a family history of sudden cardiac death, prolonged QT syndrome, hypertrophic cardiomyopathy or a personal history of unexplained chest pain, shortness of breath or episodes of syncope(passing out), then a visit to a cardiologist would be warranted.

The long and short of this data is great news for medicine users. Take the medicines, if you have to, and be secure in the fact that you have little risk for heart related issues.

Dr. M