This Article Free upon publication Full Text Full Text (PDF) Correction Correction (v120,pe55) All Versions of this Article: 117/18/2407    most recent CIRCULATIONAHA.107.189473v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vetter, V. L. Articles by Webb, C. L. Search for Related Content PubMed PubMed Citation Articles by Vetter, V. L. Articles by Webb, C. L. Related Collections Other Ethics and Policy Cardiovascular Pharmacology Cerebrovascular disease/stroke Electrocardiology AHA Statements and Guidelines Arrhythmias, clinical electrophysiology, drugs

(Circulation. 2008;117:2407-2423.)
© 2008 American Heart Association, Inc.

AHA Scientific Statement

Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder

A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing

Victoria L. Vetter, MD, FAHA, Chair; Josephine Elia, MD; Christopher Erickson, MD; Stuart Berger, MD, FAHA; Nathan Blum, MD; Karen Uzark, RN, PhD, FAHA; Catherine L. Webb, MD, FAHA

Key Words: AHA Scientific Statements • attention deficit disorder with hyperactivity • cardiovascular monitoring • congenital heart disease • stimulant drugs • death, sudden • heart arrest • pediatrics

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Over the past decade, concerns have been raised regarding the safety of a variety of psychotropic medications in children and adolescents, the appropriate selection of patients for therapy, and the indications for cardiovascular monitoring. In 1999, concerns over potential cardiovascular effects of psychotropic drugs, especially tricyclic antidepressants^1,2 but including stimulants, prompted the American Heart Association (AHA) scientific statement "Cardiovascular Monitoring of Children and Adolescents Receiving Psychotropic Drugs."³ At that time, no specific cardiovascular monitoring was recommended for the use of stimulant medications. Since that time, a constellation of circumstances have come together, necessitating a second look at this complicated issue. These circumstances include an increased awareness of the presence of attention deficit/hyperactivity disorder (ADHD) in the general population and in children with preexisting cardiac conditions; public concerns about the side effects and toxicities of medications, especially psychotropic medications in children; and regulatory factors and warnings issued by the US Food and Drug Administration (FDA) and by the pharmaceutical industry in response to the FDA. This writing group was convened in response to FDA concerns with regard to the safety of the ADHD drugs and with regard to the identification of children with underlying cardiovascular abnormalities.

At a time when there is much discussion of the side effects of drugs and of the use of psychotropic drugs in children in the media and lay literature, it is particularly important for the medical profession to play a significant role in critically evaluating the use of stimulant medication in children, including those who . . . [Full Text of this Article]

This article has been cited by other articles:

				M. McLeod, T. Laubscher, L. Regier, and B. Jensen Taking the stress out of individualizing ADHD drug therapy Can Fam Physician, September 1, 2009; 55(9): 895 - 898. [Full Text] [PDF]

				M. S. Gould, B. T. Walsh, J. L. Munfakh, M. Kleinman, N. Duan, M. Olfson, L. Greenhill, and T. Cooper Sudden Death and Use of Stimulant Medications in Youths Am J Psychiatry, September 1, 2009; 166(9): 992 - 1001. [Abstract] [Full Text] [PDF]

				B. Vitiello and K. Towbin Stimulant Treatment of ADHD and Risk of Sudden Death in Children Am J Psychiatry, September 1, 2009; 166(9): 955 - 957. [Full Text] [PDF]

				W. B. Brinkman, S. N. Sherman, A. R. Zmitrovich, M. O. Visscher, L. E. Crosby, K. J. Phelan, and E. F. Donovan Parental Angst Making and Revisiting Decisions About Treatment of Attention-Deficit/Hyperactivity Disorder Pediatrics, August 1, 2009; 124(2): 580 - 589. [Abstract] [Full Text] [PDF]

				G. Bates Drug treatments for attention-deficit hyperactivity disorder in young people Adv. Psychiatr. Treat., May 1, 2009; 15(3): 162 - 171. [Abstract] [Full Text] [PDF]

				B. J Cowles Lisdexamfetamine for Treatment of Attention-Deficit/Hyperactivity Disorder Ann. Pharmacother., April 1, 2009; 43(4): 669 - 676. [Abstract] [Full Text] [PDF]

				A. D. Mosholder, K. Gelperin, T. A. Hammad, K. Phelan, and R. Johann-Liang Hallucinations and Other Psychotic Symptoms Associated With the Use of Attention-Deficit/Hyperactivity Disorder Drugs in Children Pediatrics, February 1, 2009; 123(2): 611 - 616. [Abstract] [Full Text] [PDF]

				L. K. Leslie, M. E. Alexander, T. A. Trikalinos, J. T. Cohen, S. K. Parsons, and J. W. Newburger Reexamining the Emperor's New Clothes: Ambiguities in Current Cardiac Screening Recommendations for Youth With Attention Deficit Hyperactivity Disorder Circ Cardiovasc Qual Outcomes, November 1, 2008; 1(2): 134 - 137. [Full Text] [PDF]

				J. Conway, K. K. Wong, C. O'Connell, and A. E. Warren Cardiovascular Risk Screening Before Starting Stimulant Medications and Prescribing Practices of Canadian Physicians: Impact of the Health Canada Advisory Pediatrics, October 1, 2008; 122(4): e828 - e834. [Abstract] [Full Text] [PDF]

				J. M. Perrin, R. A. Friedman, T. K. Knilans, the Black Box Working Group, and the Section on Cardiology and Cardiac Surgery Cardiovascular Monitoring and Stimulant Drugs for Attention-Deficit/Hyperactivity Disorder Pediatrics, August 1, 2008; 122(2): 451 - 453. [Full Text] [PDF]

				L. O'Keefe ECGs for all ADHD patients? * AAP-AHA release joint 'clarification' on AHA recommendation AAP News, June 1, 2008; 29(6): 1 - 1. [Full Text] [PDF]

				D. Bernhardt ECG Screening of Young Athletes for Cardiac Disease AAP Grand Rounds, June 1, 2008; 19(6): 63 - 64. [Full Text] [PDF]

				AHA Statement on Stimulants and Cardiovascular Screening Journal Watch Cardiology, May 28, 2008; 2008(528): 1 - 1. [Full Text]