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ADHD drugs may raise risk of sudden death

A study published in the American Journal of Psychiatry indicates that there may be an increased risk of sudden death in children

A study published in the American Journal of Psychiatry indicates that there may be an increased risk of sudden death in children, without heart abnormalities, taking stimulants to treat attention deficit hyperactivity disorder (ADHD). Researchers from New York State Psychiatric Institute, Columbia University and the Nathan Kline Institute obtained data from autopsy reports, toxicology results and direct interviews with parents.

Among 564 cases of sudden unexplained death in children 10 (1.8 per cent) were being treated with a stimulant drug – in all cases methylphenidate (Ritalin). In a control group of children killed in motor vehicle accidents only two children (0.4 per cent) were taking a stimulant drug, and of these one was taking Ritalin.

The FDA issued a warning in 2006 that stimulant drugs "generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems". However this study indicates that children without pre-existing heart conditions may be at risk. 

The study's authors acknowledge that it has a number of limitations – for example it does not rule out the possibility that ADHD itself may increase the probability of sudden death – but it does suggest that further investigation into the potential risks of prescribing stimulant drugs in children and adolescents is warranted.

16th June 2009

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