Key result
This review addresses the cardiovascular safety of Atomoxetine and Methylphenidate in children with ADHD, providing guidance on pre-treatment screening and cardiology referral.
Why the study?
While atomoxetine and methylphenidate are linked to ventricular arrhythmias and sudden death in adults, evidence in children remains unclear, leaving pediatric psychiatrists uncertain about cardiac assessment and referral.
What are the appropriate cardiac screening and follow-up protocols for children prescribed atomoxetine or methylphenidate for ADHD?
What are the appropriate cardiac screening and follow-up protocols for children prescribed atomoxetine or methylphenidate for ADHD?
Answers are grounded in this paper and cite their sources.
This review addresses the cardiac safety of ADHD medications in children, providing guidance on pre-treatment screening and cardiology referral.
The current treatment of Attention Deficit Disorder and Attention Deficit with Hyperactivity consists mainly in the administration of Straterra (Atomoxetine) Concerta and Ritalin (Methylphenidate). The FDA warned that the products might increase systolic, diastolic blood pressure, and lead to ventricular arrhythmias. Arrhythmic events and sudden cardiac death were described in adults with preexistent heart disease. However, studies on children have failed to demonstrate a clear association between the arrhythmic events and these drugs, as demonstrated in adults. What should the attitude of the pediatric psychiatrist be towards the administration of these products? What examination should be made by the psychiatrist before referring the child to a pediatric cardiologist? Which patients need a cardiology consultation before the administration of these products? What is the follow-up after drug initiation? These are some questions that this paper aims to answer.
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Cismaru et al. (2021) conducted a review in Attention Deficit Disorder and Attention Deficit with Hyperactivity. Atomoxetine and Methylphenidate was evaluated. This review addresses the cardiovascular safety of Atomoxetine and Methylphenidate in children with ADHD, providing guidance on pre-treatment screening and cardiology referral.
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