ADHD Drugs Linked to Kids' Deaths

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For parents of kids with ADHD, medication can often seem like a godsend. Recent studies have shown that kids who take these drugs specifically for a diagnosed condition perform better in school, for example. But a new study released this week in the online edition of the "American Journal of Psychiatry" is raising red flags: The study found that teens and children taking ADHD medications are seven times more likely than their peers to die suddenly.

That's disheartening news for many kids and their parents.

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An estimated 2.5 million American children take ADHD medication; in the early 1990s there were several cases of sudden unexplained deaths of children taking these meds. But because the cases were so rare, scientists were unable to gather a large enough sample to draw any real conclusions.

This new study compares 564 cases of sudden death in children ages 7 to 19 which occured between 1985 and 1996. Those cases were compared with an equal number of deaths of children who died in car accidents. The scientists sifted through data to weed out any complications that might have caused the unexplained deaths, including asthma and heart problems. Once they did that, they were left with ten unexplained deaths. Those ten cases were compared to cases of kids the same ages who had died in car crashes; the children on the stimulant medication were found to be 7.4 percent more likely to die suddenly.

Dr. Madelyn Gould, the study's author, was stunned by the findings. "What we found -- to our surprise -- is that even if you take out confounding factors, the association between stimulant use and sudden death was still significant," she says. But Dr. Gould, a professor of clinical epidemiology in psychiatry at Columbia University/New York State Psychiatric Institute in New York City, sees no need for parents to panic. "I'm confident the association is real and significant, but it's very rare. I don't want our findings to change prescribing patterns or for a parent to change their willingness to use stimulant medications if they're called for, but physicians should monitor patients with any new medication you give a young person."

So how concerned should parents be? The study authors suggest that parents should be vigilant but not frightened. "No medication is free of risk or side effects. Any time we prescribe any medication, we have to balance its benefits and risks," said Dr. Diego Chaves-Gnecco, a developmental-behavioral pediatrician at Children's Hospital of Pittsburgh. "The most important point is to make sure that everyone is well-educated and that a conscientious screening has been done." Currently, physicians prescribing ADHD meds are directed to take a detailed family history, with special attention to any history of heart disease, before putting a patient on medication.

What should you do if your child is currently taking ADHD medication? Talk to the prescribing doctor if you have concerns. But the study's authors warn parents not to suddenly stop a child's meds. Always call your doctor before you change doses or stop any medication. And remember: These are serious drugs that your child is taking, and the process of prescribing and monitoring them should be taken very seriously.

Dr. Benedetto Vitiello, a psychiatrist and chief of the child and adolescent treatment intervention branch at the U.S. National Institute of Mental Health, summed it up this way: "We need to keep in mind that even though these drugs are commonly used, they still have the potential for adverse events. We shouldn't approach them lightly."

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