"Although the evidence base for the cardiac effects of central nervous system stimulants that are used for the treatment of...ADHD is still unsatisfactory, concerns have resulted in a Food and Drug Administration (FDA) mandate for medication guides to alert patients to potential cardiovascular risks and adverse psychiatric symptoms," write Almut Gertrud Winterstein, PhD, from the Department of Pharmaceutical Outcomes and Policy at the College of Pharmacy, and the Department of Epidemiology and Biostatistics at the College of Public Health and Health Professions, University of Florida, Gainesville, and colleagues.
They write that clinical trial data have shown evidence of cardiac adverse effects, including increases in heart rate and blood pressure and case reports of cardiac sudden death, in children exposed to stimulants. In addition, the authors published a recent cohort study of more than 50,000 children with ADHD that showed a 20% increased risk for cardiac ED visits for all stimulants combined.
The investigators used claims data from the Florida Medicaid fee-for-service program, which represented 2,131,953 children and adolescents. They analyzed data from 30,576 patients newly diagnosed with ADHD who were between the ages of 3 and 20 years, enrolled between July 1994 and June 2004, and newly prescribed methylphenidate (n = 18,238) or amphetamine salts (mixed amphetamine salts or dexamphetamine, n = 17,175).
Overall, the authors conclude, "Additional population-based studies that address manifestation of serious heart disease, especially after long-term use, dosage comparisons, and interactions with preexisting cardiac risk factors are needed to inform psychiatric treatment decisions."
Bonnie - and there are calls from the public to make these medications over-the-counter to improve performance of daily tasks?
No comments:
Post a Comment