ADHD Medications and Children's Heart Conditions

05/23/08 Diagnosis

According to a recent recommendation by the American Heart Association, children diagnosed with attention deficit and hyperactivity disorder (ADHD), should have a thorough heart examination before taking medication to treat the condition.

ADHD affects roughly 4 percent to 8 percent of American children aged four to 17. It’s a tricky diagnosis; some experts think this number is too low while other feel the condition is over diagnosed. Regardless, it is generally agreed that, left untreated, children with ADHD are at increased risk of problems including failure in school, car accidents, and substance abuse.

The most commonly prescribed medications for ADHD are stimulants including Ritalin, Adderall, and Strattera. Although stimulants increase the heart rate and blood pressure, no significant link between heart problems and taking these medications has been found. However, some children taking these medications—especially those with certain forms of congenital (inborn) heart disease or documented heartbeat irregularities—may be more likely to experience sudden cardiac arrest which can be fatal. The symptoms of a potentially dangerous heart condition in children are subtle and are doctors don’t always investigate them when prescribing drugs for ADHD.

If your child is diagnosed with ADHD and medication is prescribed, the doctor should assess the child’s cardiac history as well as family heart health history. They will look episodes of fainting or dizziness, heart palpitations, murmurs or unexplained inability to exercise. Kids should be checked for abnormal heartbeat, high blood pressure, and any suggestion of Marfan’s syndrome, a connective tissue disorder that affects the heart.

If everything is normal, most doctors will prescribe the medication and simply perform heart checkups on a regular basis. Some experts feel an EKG is necessary. Critics say an unnecessary EKG puts additional stress on the child and family.

A movement is afoot to establish a registry of cases of sudden cardiac death in children, teens and young adults. One goal of the registry would be to learn more about the role of ADHD drugs in such cases and investigate links between these drugs and cardiac death.

Mari S. Gold is has written for The New York Times, American Profile, Relish Magazine, TravelSmart, Indianapolis Monthly, and numerous e-zines. An avid cook and foodie, she contributes restaurant reviews to Zagat Guides and The Vermont News Guide, and is working on a young adult novel with a food theme. Married with grown children and two cats, she divides her time between New York City where she is director of communications for a major health care organization, and Dorset, Vermont.