ADHD Stimulants Found Safe for Children with Congenital Heart Disease

A new study challenges conventional logic on stimulant medications, finding that children diagnosed with ADHD who have congenital heart disease can safely take these drugs without fear of adverse cardiac side effects.

The study, carried out by researchers at Cincinnati Children’s Hospital Medical Center, looked at 44 children between the ages of six and 18, all of whom had ADHD and congenital heart disease. They compared these patients to another group of children who had similar heart disease but were not treated with stimulants.

Researchers found that both groups had equal risks of sudden death, increased heart rate, and blood pressure changes, as measured by electrocardiograms — indicating that the stimulant medications did not pose any additional risk to the children’s hearts. In addition, the group with ADHD saw significant improvement in their symptoms of inattention, hyperactivity, and impulsivity, further reinforcing the overall efficacy of stimulant medications in the treatment of attention deficit.

"Children with congenital heart disease are at high risk for ADHD, but fears about cardiovascular side effects, including sudden death, limit the use of stimulant medications," says Julia Anixt, M.D., the senior author of the study. "This study indicates that stimulants are both effective and safe when prescribed with appropriate monitoring and in collaboration with the patient's cardiologist."

Side effects of stimulants have been known to include increased heart rate and blood pressure, both of which can have adverse effects on the heart. Since 2006, stimulant medications have carried a warning indicating that the drugs can exacerbate existing cardiovascular problems and should be taken with caution. Between 1999 and 2003, 19 children died while taking ADHD stimulant medications; five of those children had a structural heart defect.

The Cincinnati study was small, and more research will be needed to support its claims. Parents of children with both ADHD and congenital heart disease should work closely with their doctors to figure out the best treatment choices for their unique situation.