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Two American Associations Disagree: Are ECGs Necessary For ADHD Kids Or Not?

 
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Prescribed stimulants are mainly used in treating ADHD, Attention Deficit and Hyperactivity Disorder, in children (and adults).

Other types of stimulants are coffee, nicotine, cocaine, etc.

ADHD is the most common neurobehavioral disorder in children and about 2.5 million children are taking stimulants for it. Stimulants are meant to improve concentration, decrease appetite, reduce sleepiness and improve fatigue. Yet, they may cause increased heart rate, blood pressure, increased anxiety, heart problems, etc. And of course, abuse and addiction is common resulting in dependence, tolerance, withdrawal symptoms, and other problems.

In 2008, the AHA, American Heart Association, reported that from 1999 through 2003, 19 sudden cardiac deaths and 26 cardiovascular events were reported in children under 18 who received ADHD medications. The AHA wanted to reduce these possible heart related incidences by identifying those children with undiagnosed heart problems before starting them on medications such as Ritalin or Adderall. And so, the AHA recommended that an ECG, electrocardiogram, be performed prior to taking the medications. The ECG records the electrical activity of the heart, is noninvasive, fairly inexpensive, and takes about 5 minutes to perform.

The AAP, American Academy of Pediatrics, and other societies, associations and organizations responded by stating that there is no clinical evidence of increased occurrences of sudden cardiac death in children than in the general population. Rather, the physician should perform a physical exam with a special focus on the cardiovascular system, take a history, and monitor the child while on the stimulant therapy.

Read the whole article in Circulation – Journal of the American Heart Association

And the opposing view in the Official Journal of the American Academy of Pediatrics

Do you think the American Heart Association is being overly cautious in its recommendations?

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