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Pediatricians Split on Heart Tests Before Kids' ADHD Meds
Date:1/16/2012

By Jenifer Goodwin
HealthDay Reporter

MONDAY, Jan. 16 (HealthDay News) -- Some pediatricians continue to do electrocardiograms (EKGs) on children before starting them on medication for attention-deficit hyperactivity disorder, new research suggests, even though many experts say the latest evidence shows it isn't really necessary.

Several years ago, reports of sudden death, heart attack and stroke among children and adults taking stimulants to treat ADHD caused alarm among parents and health care providers about the safety of the medications.

The reports prompted Canadian health authorities to briefly pull Adderall from the market in 2005, while the U.S. Food and Drug Administration now requires that ADHD drugs carry a "black box" label warning about potential heart risks.

Further research suggested that the risk may only be to children who had underlying heart defects, such as some congenital abnormalities and arrhythmias. On Adderall, for example, the warnings now read: "Sudden death has been reported in association with CNS [central nervous system] stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems."

A few years ago, the American Heart Association stated that it would be "reasonable" to give kids EKGs, which look for abnormalities in the heart's electrical activity, before starting them on stimulant medication.

But in 2008, the American Academy of Pediatrics (AAP) issued a policy statement saying that routine EKGs prior to starting kids on ADHD medications wasn't necessary.

"A lot of pediatricians started doing EKGs, and then when the AAP said it didn't agree with that, pediatricians scaled back," explained Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven & Alexandra Cohen Children's Medical Center of New York.

And two major recent studies have found no hearts risk associa
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