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(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]

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