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Specialties Disagree on Need for ECG Evaluations Before Prescribing ADHD Drugs
The American Academy of Pediatrics disagrees with an earlier American Heart Association recommendation that children routinely be given electrocardiograms before receiving drugs for attention deficit/hyperactivity disorder.
The AHA made the recommendation in April because of concerns that stimulants such as Ritalin may increase the risk for sudden cardiac death in children with congenital heart disease.
Then in May, the AHA and the AAP released a joint statement, saying that it was "reasonable" for a physician to obtain an ECG before starting therapy, but it was at the physician's discretion.
The AAP's latest response, published online in Pediatrics, contends there's no compelling evidence that children treated for ADHD have an elevated risk for sudden death or that ECG screening will lower it. Instead, the pediatrics academy encourages physicians to assess all children for cardiac abnormalities by using history and physical assessment and to treat children with ADHD without obtaining ECGs.
LINK(S):
AAP policy statement (Free)
AHA scientific statement (Free)
Physician's First Watch coverage of original AHA statement (Free)
Published in Physician's First Watch August 4, 2008
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