June 15, 2009

FDA Links ADHD Stimulants To Sudden Death In Healthy Children

News is just out that the FDA's ongoing review of the safety of stimulants (Adderall, etc.) used to treat ADHD in children has found an "association" between the meds and sudden death in otherwise healthy children. The FDA specifically noted:

"FDA notified healthcare professionals that it is providing its perspective on study data published in the American Journal of Psychiatry on the potential risks of stimulant medications used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children. This study, funded by the FDA and the National Institute of Mental Health (NIMH), compared the use of stimulant medications in 564 healthy children from across the United States who died suddenly to the use of stimulant medications in 564 children who died as passengers in a motor vehicle accident.The study authors concluded that there may be an association between the use of stimulant medications and sudden death in healthy children. Given the limitations of this study’s methodology, the FDA is unable to conclude that these data affect the overall risk and benefit profile of stimulant medications used to treat ADHD in children. FDA believes that this study should not serve as a basis for parents to stop a child’s stimulant medication."

I'm not sure why the study wouldn't prompt such action or at least a deep reexamination of stimulants a child may be taking.

Any study like this does have limitations and the data for the FDA's study go back into the 1980s, but this new finding should give parents and doctors much pause.

You can read the full study here and an accompanying editorial in the American Journal of Psychiatry wherein researchers hail the power of stimulants and call the sudden death risk "very small."

Not if it's your kid.

Posted by Philip Dawdy at June 15, 2009 11:04 AM
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Comments

Wait a second, adhd meds are amphetamines. Amphetamines are known to be dangerous and addictive killers because I think among other things they destroy your heart, so children who take them die of heart attacks like all speed freaks. This is to be expected. Methamphetamine, i.e. crystal meth, is illegal and it is essentially the same exact drug as these drugs, the differences between crystal meth and adderall or ritalin being sort of like the differences in whiskey and vodka, insignificant.

What amazes me is the baloney backed up by no science that says that adhd is a real medical disease that causes the body not to be harmed by amphetamines. You know the speed makes hyperactive kids normal schtick. Know what, speed makes anybody hyperattentive as long as you increase the dosage until you become so addled that you lose all ability to focus (in illicit "drug addicts" known as freaking out, hitting bottom, etc.; in kids with adhd, known as getting relabeled as child bipolar or schizophrenic).

What if these children were being treated with vodka, would we be surprised when they died of liver cirrhosis ?

Posted by: Sally at June 16, 2009 06:03 AM

from May 2008

http://bipolarsoupkitchen-stephany.blogspot.com/2008/05/heart-tests-encouraged-for-kids-taking.html

"April 22, 2008
A new recommendation was recently given by the American Heart Association to children with attention deficit and hyperactivity disorder.

The agency is encouraging children who have been diagnosed with ADD to get a thorough heart analysis, including an electrocardiogram, before taking prescription medication for the condition.

Link Between Medications and Heart Problems

Health experts hope that having heart tests will help avoid sudden cardiac arrest and other health complications that have been associated with the medicines.

According to research, since 1999, an estimated 30 child deaths have been associated with children who have taken prescribed medications like Ritalin.

http://www.adrugrecall.com/news/kids-heart-tests.html

Posted by: Stephany at June 16, 2009 07:32 AM

Thanks, Stephany. I just passed this on to a friend of mine who adores medications. She and her daughter pop every pill in sight. I was appalled a couple of years ago when we took her kid to summer camp. She handed me a small (larger than lunch bag size, though) paper sack and said "Hold this. We have to take it to the camp nurse later." It was at least half full of PILLS! This is a perfectly normal child. I was horrified. Kids never took pills when I was a kid. An aspirin for a fever, that was about it.

I felt even more gobsmacked when I looked around the cabin and realized every single child there had their own sack of pills. This is really disgusting to me.

I doubt mother will listen and I guarantee you her doc never told her about this, but I sent it to her anyway. Here's what I found interesting: It was dated April 2008. So how come this wasn't big news??? How come every doc in the country wasn't giving kids EKGs??? How did we get to a place where we consider it acceptable to flat-out risk cardiac arrest in a certain number of kids rather than putting up with high energy or finding behavioural solutions? I'm talking about the fact we've drugged these kids wholesale. For a few, very few kids there may be no other way. But to actually prescribe them wholesale when you *know* this risk is so unacceptable. And to not inform the parents of the risk is even more so.

Posted by: Sherry at June 16, 2009 01:35 PM

Sherry, that's what I thought when I found that article in 2008. I think a good doctor would do an entire workup on a child or adult, before any psych med is given, for a body function baseline, like heart health, lipids, diabetes, etc. at least then if issue come up one can add in the med as a factor and have an actual medical baseline for "proof" it's the meds.

Posted by: Stephany at June 16, 2009 06:07 PM

I doubt they did much research for that 2008 article. I bet if I spent an hour or two looking on the internet I could find the names of a lot more than 30 kids. Here's what I found in 5 minutes:

Feb-08-06:

FDA reports 51 deaths of children and adults taking ADHD drugs such as Ritalin and Adderall. The FDA plans to investigate a risk of sudden death, high blood pressure, heart attacks and strokes in patients taking ADHD medication. [WASHINGTON POST]

http://www.ritalindeath.com

Between 1990 and 2000 there were 186 deaths from methylphenidate reported to the FDA MedWatch program…

Our fourteen year old son Matthew suddenly died on March 21, 2000. The cause of death was determined to be from the long-term (age 7-14) use of Methylphenidate...
"I was told by one of the medical examiners that a full-grown man's heart weighs about 350 grams and that Matthew's heart's weight was about 402 grams. Dr. Dragovic said this type of heart damage is smoldering and not easily detected with the standard test done for prescription refills. The standard test usually consists of blood work, listening to the heart, and questions about school behaviors, sleeping and eating habits.
*What is important to note here is that Matthew did not have any pre-existing heart condition or defect."

Posted by: Damaged at June 17, 2009 04:48 AM

Stephany,
As I expected, I got a snippy little note from mother this morning basically telling me to mind my own business. I was very careful to couch the information in an "I know you soft peddle the use of ritalin, but thought you might find this of interest" manner.

Well, it's not my kid and mother just loves drugs so I will keep my mouth shut from now on. The sad thing is I've seen the kid off ritalin on weekends and summers and can't really tell the difference from when she's on, other than she's mildly more active and yes, I would find that somewhat annoying. But I don't really like kids much in the first place. This kid is very nice and certainly not anywhere near what even I would call hyper when she's not medicated.

For this we risk sudden cardiac arrest??? Go figure.

Thanks.
S.

Posted by: Sherry at June 17, 2009 07:25 AM

Sorry to go against the grain here, but I think it should have been common sense from the start to have children thoroughly checked for heart problems before taking a drug that is known to increase blood pressure and heart rate among other things. The type of "standard test" you're talking about should occur regularly WITHOUT taking such a drug. Extensive blood work, and EKG are important, but so is consistent monitoring of blood pressure and heart rate (at home), and things like a 24 hour heart monitor, echocardiogram, and some sort of stress test should be routine while on this medication. It is the doctors, parents, and teachers faults for not thinking about this stuff before dosing a child with stimulants. Kids like to run, jump around, stand on their heads and do crazy things we adults don't usually do. They also don't have a tolerance to stimulants like coffee that some of us adults have.

The deaths reported are probably also more common with high doses which seem to be pretty common in young children. Usually they (doctors) up the dose if the parents are complaining that the kid is misbehaving or is still hyperactive without ever taking into account that that might just be the way kids are, rather than testing the child based on how well he is able to focus and get things done. Another common mistake is dosing children without any family psychotherapy, including parental coaching, cognitive behavioral therapy and ADHD coaching for the child.

I have been taking Vyvanse, an extended release amphetamine for a few months now and I'm fine with even a relatively low dose (equivalent to 10mg Adderall XR), yet I see some people putting their 5, 6 and 7 year olds on as high as 150mg in some forums which would be an equivalent of 80mg of Adderall XR or 40mg of Adderall twice a day. You can see why this would be a problem for ANYONE.

I was suffering from severe depression and anxiety which I now know to be caused by a lifetime of ADD. I too thought it was nonsense, didn't believe in medicine, tried all other natural "remedies" and alternative approaches, until I turned 26 and couldn't deal with not having any kind of a life (no social, no job, no school (dropped out)) and being miserable and suicidal all the time. It also led me to have severe mood swings which were almost identical to bipolar or psychotic episodes. Had doctors prescribe me all kinds of antidepressants that usually only made me feel worse because of their horrible side effects, and did nothing for the depression or anxiety. Made a decision to go back to therapy finally and broke away from my fear of medicine and saw a psychiatrist, once again tried a few antidepressants but finally hit on to something with the stimulants. After a lifetime of misery, I am now on my way to success as I am finally more productive, and have much greater self esteem, much more positive outlook on life, and can't wait to live another day. I just wish I had done it earlier.

There's always going to be tolerance buildup and psychological dependance and possibly addiction and abuse, but sometimes that's a risk you have to take if you want to live any kind of life with this illness, and @ Sally: it is in fact a real illness, moreso than depression and their so called serotonin chemical imbalance (see the latest update on serotonin gene not linked to depression) but I haven't heard seen any science reports that say stimulants can't cause ADHD sufferers harm. It's simply that the benefits usually outweigh the risks if the individual is healthy, and everything is done properly as far as testing, dosing, and overall therapy goes.

Bottom line: Is amphetamine healthy? Heck no. But neither is living a miserable life. Did you know that ADHD children who don't get some kind of treatment, either pharmaceutical or psychological, usually tend to wind up on drugs later in life anyway? Is it worth letting your child suffer just because some people are too stupid to get their kids tested properly, find the right dosage, go to therapy, and know the difference between hyperactivity and just being a kid? Think about it.

Posted by: marcus at June 18, 2009 01:14 AM
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