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Stimulant Medications Linked to Sudden Death in Youths
Stimulant drugs commonly given for ADHD are associated with an increase in sudden unexplained deaths in young people, according to a retrospective case-control study published online by the American Journal of Psychiatry. The FDA, citing methodological limitations, said in response that it believes the study "should not serve as a basis for parents to stop a child's stimulant medication."
In the study, researchers matched each of 564 cases of sudden unexplained deaths in youths (aged 7 through 19) with one who died as a passenger in a motor vehicle accident. Using toxicology data, autopsy reports, and surveys completed by parents, researchers found an odds ratio for stimulant (methylphenidate) use of 7.4 among the unexplained deaths.
The FDA advises that prescribing physicians take a medical history and do a physical exam "with special focus on the cardiovascular system," and to consider additional tests, such as an echocardiogram or an ECG, "if the history or examination suggests underlying risk for or the presence of heart disease."
LINK(S):
American Journal of Psychiatry article (Free PDF)
American Journal of Psychiatry editorial (Free PDF)
FDA communication about stimulant safety review (Free)
Physician's First Watch coverage of ECGs and prescribing ADHD drugs (Free)
Published in Physician's First Watch June 16, 2009
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