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Safety of stimulant medications for attention deficit hyperactivity disorder in paediatric congenital heart disease

Corresponding Author

Lorraine M Chung

[email protected]

orcid.org/0000-0003-0207-0435

Department of Child and Adolescent Health Unit, Mackay Base Hospital, Mackay, Queensland, Australia

Correspondence: Dr Lorraine M Chung, Department of Child and Adolescent Health Unit, Mackay Base Hospital, 475 Bridge Road, Mackay, Qld 4740, Australia. email: [email protected]

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Gopakumar Hariharan,

Gopakumar Hariharan

orcid.org/0000-0002-6298-5066

Department of Child and Adolescent Health Unit, Mackay Base Hospital, Mackay, Queensland, Australia

School of Medicine, James Cook University, Mackay, Queensland, Australia

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Suraj Varma,

Suraj Varma

orcid.org/0000-0003-4155-1952

MonashHeart & Monash Children's Hospital, Monash Health, Melbourne, Victoria, Australia

Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia

Department of Paediatrics, Monash University, Melbourne, Victoria, Australia

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Lorraine M Chung,

Corresponding Author

Lorraine M Chung

[email protected]

orcid.org/0000-0003-0207-0435

Department of Child and Adolescent Health Unit, Mackay Base Hospital, Mackay, Queensland, Australia

Correspondence: Dr Lorraine M Chung, Department of Child and Adolescent Health Unit, Mackay Base Hospital, 475 Bridge Road, Mackay, Qld 4740, Australia. email: [email protected]

Search for more papers by this author

Gopakumar Hariharan,

Gopakumar Hariharan

orcid.org/0000-0002-6298-5066

Department of Child and Adolescent Health Unit, Mackay Base Hospital, Mackay, Queensland, Australia

School of Medicine, James Cook University, Mackay, Queensland, Australia

Search for more papers by this author

Suraj Varma,

Suraj Varma

orcid.org/0000-0003-4155-1952

MonashHeart & Monash Children's Hospital, Monash Health, Melbourne, Victoria, Australia

Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia

Department of Paediatrics, Monash University, Melbourne, Victoria, Australia

Search for more papers by this author

First published: 15 February 2023

https://doi.org/10.1111/jpc.16380

Citations: 1

Conflict of interest: None declared.

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Abstract

Aim

To review current literature regarding the safety of stimulant medications for treatment of attention deficit hyperactivity disorder in paediatric congenital heart disease (CHD) patients.

Methods

Embase, MEDLINE complete, CINAHL complete and Psychology and Behavioural Sciences Collection were searched for relevant articles from January 1980 to July 2022.

Results

One hundred and three articles were identified during the initial search after removal of duplicates. Thirty-five articles were selected for review and 11 were included as relevant to the clinical question.

Conclusions

Stimulant medications are safe in patients with underlying CHD. In mild congenital cardiac conditions (ventricular septal defect, atrial septal defect and isolated semilunar valve disease), paediatricians can safely initiate stimulant therapy. With complex CHD cases, cardiology opinion is recommended prior to starting stimulants.

Supporting Information

References

1 NICE. Attention Deficit Hyperactivity Disorder: Diagnosis and Management, 23–4. London: National Institute for Health and Clinical Excellence; 2018.
Google Scholar
2Gothelf D, Gruber R, Presburger G et al. Methylphenidate treatment for attention-deficit/hyperactivity disorder in children and adolescents with velocardiofacial syndrome: An open-label study. J. Clin. Psychiatry 2003; 64: 1163–9.
10.4088/JCP.v64n1004
CAS PubMed Web of Science® Google Scholar
3Pierick AR, Lynn M, McCracken CM, Oster ME, Iannucci GJ. Treatment of attention deficit/hyperactivity disorder in children with CHD. Cardiol. Young 2021; 31: 969–72.
10.1017/S1047951120004965
PubMed Web of Science® Google Scholar
4Rohatgi RK, Bos JM, Ackerman MJ. Stimulant therapy in children with attention-deficit/hyperactivity disorder and concomitant long QT syndrome: A safe combination? Heart Rhythm 2015; 12: 1807–12.
10.1016/j.hrthm.2015.04.043
PubMed Web of Science® Google Scholar
5Trairatvorakul P. Cardiovascular safety of stimulant medication in children with congenital heart disease and attention deficit/hyperactivity disorder [Master's thesis]. Cincinnati: University of Cincinnati; 2016. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459529300.
Google Scholar
6Zhang C, Kutyifa V, Moss AJ, McNitt S, Zareba W, Kaufman ES. Long-QT syndrome and therapy for attention deficit/hyperactivity disorder. J. Cardiovasc. Electrophysiol. 2015; 26: 1039–44.
10.1111/jce.12739
PubMed Web of Science® Google Scholar
7Buchhorn R, Müller C, Willaschek C, Norozi K. How to predict the impact of methylphenidate on cardiovascular risk in children with attention deficit disorder: Methylphenidate improves autonomic dysfunction in children with ADHD. ISRN Pharmacol. 2012; 2012: 170935.
10.5402/2012/170935
PubMed Google Scholar
8Cooper WO, Habel LA, Sox CM et al. ADHD drugs and serious cardiovascular events in children and young adults. N. Engl. J. Med. 2011; 365: 1896–904.
10.1056/NEJMoa1110212
CAS PubMed Web of Science® Google Scholar
9Gould MS, Walsh BT, Munfakh JL et al. Sudden death and use of stimulant medications in youths. Am. J. Psychiatry 2009; 166: 992–1001.
10.1176/appi.ajp.2009.09040472
PubMed Web of Science® Google Scholar
10Schelleman H, Bilker WB, Strom BL et al. Cardiovascular events and death in children exposed and unexposed to ADHD agents. Pediatrics 2011; 127: 1102–10.
10.1542/peds.2010-3371
PubMed Web of Science® Google Scholar
11Shin J-Y, Roughead EE, Park B-J, Pratt NL. Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): Nationwide self controlled case series study. BMJ 2016; 353: i2550.
10.1136/bmj.i2550
PubMed Google Scholar
12Winterstein AG, Gerhard T, Kubilis P et al. Cardiovascular safety of central nervous system stimulants in children and adolescents: Population based cohort study. BMJ 2012; 345: e4627.
10.1136/bmj.e4627
PubMed Web of Science® Google Scholar
13Wernovsky G. Current insights regarding neurological and developmental abnormalities in children and young adults with complex congenital cardiac disease. Cardiol. Young 2006; 16: 92–104.
10.1017/S1047951105002398
PubMed Web of Science® Google Scholar
14Jenabi E, Bashirian S, Fariba F, Naghshtabrizi B. The association between congenital heart disease and the risk of autism spectrum disorders or attention-deficit/hyperactivity disorder among children: A meta-analysis. Eur. J. Psychiatry 2022; 36: 71–6.
10.1016/j.ejpsy.2021.10.001
Web of Science® Google Scholar
15Czobor NR, Ocsovszky Z, Roth G et al. ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: The role of age at operation. BMC Psychiatry 2021; 21: 316.
10.1186/s12888-021-03324-w
PubMed Web of Science® Google Scholar
16Senderey E, Sousa J, Stavitsky M. Does quality of life outweigh the cardiovascular risks of stimulant medication in a child with ADHD and hypertrophic cardiomyopathy? BMJ Case Rep. 2017; 2017: bcr2017222072.
10.1136/bcr-2017-222072
PubMed Google Scholar
17Vetter VL, Elia J, Erickson C et al. Cardiovascular monitoring of children and adolescents with heart disease receiving stimulant drugs: 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. Circulation 2008; 117: 2407–23.
10.1161/CIRCULATIONAHA.107.189473
PubMed Web of Science® Google Scholar
18Orejarena LA, Vidaillet H, DeStefano F et al. Paroxysmal supraventricular tachycardia in the general population. J. Am. Coll. Cardiol. 1998; 31: 150–7.
10.1016/S0735-1097(97)00422-1
CAS PubMed Web of Science® Google Scholar
19Schwartz PJ, Priori SG, Spazzolini C et al. Genotype-phenotype correlation in the long-QT syndrome: Gene-specific triggers for life-threatening arrhythmias. Circulation 2001; 103: 89–95.
10.1161/01.CIR.103.1.89
CAS PubMed Web of Science® Google Scholar
20Shimizu W, Antzelevitch C. Cellular basis for the ECG features of the LQT1 form of the long-QT syndrome: Effects of beta-adrenergic agonists and antagonists and sodium channel blockers on transmural dispersion of repolarization and torsade de pointes. Circulation 1998; 98: 2314–22.
10.1161/01.CIR.98.21.2314
CAS PubMed Web of Science® Google Scholar
21Vaseghi M, Shivkumar K. The role of the autonomic nervous system in sudden cardiac death. Prog. Cardiovasc. Dis. 2008; 50: 404–19.
10.1016/j.pcad.2008.01.003
CAS PubMed Web of Science® Google Scholar

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Volume59, Issue3

March 2023

Pages 580-588

Safety of stimulant medications for attention deficit hyperactivity disorder in paediatric congenital heart disease

Abstract

Aim

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Information

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Safety of stimulant medications for attention deficit hyperactivity disorder in paediatric congenital heart disease

Abstract

Aim

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

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