Ritalin Case

Stimulant medications (such as Ritalin and others) are widely used to treat attention deficit/hyperactivity disorder (ADHD) in children. They have long been known to mildly and temporarily increase heart rate and blood pressure, but in the last few years a number of cases were reported of children who had heart attacks or sudden death while they were on these drugs. Two years ago, two committees that advise the U.S. Food and Drug Administration looked into the question of whether these rare problems could actually be caused by the drugs, and while one committee thought a serious warning should be issued about a possible risk of these side effects, the other committee thought the evidence that the drugs caused such problems was quite weak, while the effectiveness of the drugs was well established.

Now, researchers have examined data from Florida Medicaid files, where they were able to identify children between 3 and 20 years of age who were prescribed stimulants for newly-diagnosed ADHD. They also looked at whether any of these children had cardiac problems that resulted in death, admission to hospital, or an emergency department visit. Among over 55,000 children in the database, 5 children died of cardiac causes, but there were no cardiac deaths among children on stimulants. Stimulants also weren't associated with an increased risk of hospital admission for cardiac reasons Of interest, the researchers found that children on stimulants were about 20% more likely to have an emergency department visit for cardiac problems, which the authors think might reflect the fact that these drugs can indeed increase heart rate and blood pressure.