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Treatment of attention deficit/hyperactivity disorder in children with CHD

Published online by Cambridge University Press:  01 February 2021

Alyson R. Pierick Open the ORCID record for Alyson R. Pierick [Opens in a new window] ,
Melodie Lynn ,
Courtney M. McCracken ,
Matthew E. Oster  and
Glen J. Iannucci
Alyson R. Pierick*
Affiliation:
Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, USA
Melodie Lynn
Affiliation:
Division of Pediatric Cardiology Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
Courtney M. McCracken
Affiliation:
Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, USA
Matthew E. Oster
Affiliation:
Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, USA
Glen J. Iannucci
Affiliation:
Emory University School of Medicine, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GA, USA
*
Author for correspondence: Dr A. R. Pierick, MD, Emory University School of Medicine, Department of Pediatrics, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA. Tel: +1 (319)541-8325; Fax: 770-488-9477. E-mail: [email protected]
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Abstract

Introduction:

The prevalence of attention deficit/hyperactivity disorder in the general population is common and is now diagnosed in 4%–12% of children. Children with CHD have been shown to be at increased risk for attention deficit/hyperactivity disorder. Case reports have led to concern regarding the use of attention deficit/hyperactivity disorder medications in children with underlying CHD. We hypothesised that medical therapy for patients with CHD and attention deficit/hyperactivity disorder is safe.

Methods:

A single-centre, retrospective chart review was performed evaluating for adverse events in patients aged 4–21 years with CHD who received attention deficit/hyperactivity disorder therapy over a 5-year span. Inclusion criteria were a diagnosis of CHD and concomitant medical therapy with amphetamines, methylphenidate, or atomoxetine. Patients with trivial or spontaneously resolved CHD were excluded from analysis.

Results:

In 831 patients with CHD who received stimulants with a mean age of 12.9 years, there was only one adverse cardiovascular event identified. Using sensitivity analysis, our median follow-up time was 686 days and a prevalence rate of 0.21% of adverse events. This episode consisted of increased frequency of supraventricular tachycardia in a patient who had this condition prior to initiation of medical therapy; the condition improved with discontinuation of attention deficit/hyperactivity disorder therapy.

Conclusion:

The incidence of significant adverse cardiovascular events in our population was similar to the prevalence of supraventricular tachycardia in the general population. Our single-centre experience demonstrated no increased risk in adverse events related to medical therapy for children with attention deficit/hyperactivity disorder and underlying CHD. Further population-based studies are indicated to validate these findings.

Keywords

Attention deficit/hyperactivity disorderCHDstimulantsarrhythmias
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 6 , June 2021 , pp. 969 - 972
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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