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Stimulant medications determined safe for children with ADHD, heart disease

Children with attention-deficit/hyperactivity disorder and congenital heart disease can use stimulant medications without facing potential cardiovascular side effects, according to study results presented at the annual meeting of the Society for Developmental and Behavioral Pediatrics in Las Vegas.

“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,” Julia Anixt, MD, a developmental and behavioral pediatrician at Cincinnati Children’s Hospital, said in a press release.

Julia Anixt

Based on reports of cardiovascular adverse events and observed physiological effects, the FDA has previously issued safety warnings for stimulant drug use in patients with pre-existing heart disease or cardiac structural abnormalities due to the risk for sudden death, stroke and myocardial infarction.

To determine the safety and efficacy of stimulant medications, such as methylphenidate and dexamfetamine, among children with congenital heart disease, Anixt and colleagues compared patients (n = 44) aged 6 to 18 years who received stimulant medications against patients with similar heart disease who were not treated with stimulants.

According to study results, researchers observed no increased risk for death or changes in cardiac vital signs, such as blood pressure or heart rate, even for children with ADHD and severe heart conditions.

In addition, Anixt and colleagues noted that patients treated with stimulant medications exhibited significant improvements in ADHD symptoms as measured by standardized rating scales.

“Stimulant medications should be considered a valid and highly effective option for ADHD treatment in children with congenital heart disease,” Anixt told Infectious Diseases in Children. “However, the risk of stimulant use varies depending on the type of heart condition, so close collaboration between prescribing physicians and cardiologists is essential to determining which patients are candidates for treatment and how frequently to monitor their cardiac status on medications.”

Disclosure: The researchers report no relevant financial disclosures.