Highlights

Drug Approval

In 2006, Daytrana was approved as the first skin patch medication for treatment of attention deficit hyperactivity disorder (ADHD). Daytrana contains methylphenidate, the same drug used in Ritalin pills.

Drug Warning

All ADHD stimulant medications now carry warnings that patients with a history of structural heart problems, high blood pressure, or disturbances in heart rhythm (arrhythmia) should not use these drugs. These warnings appear on the prescribing labels of methylphenidate (Ritalin, Concerta) and amphetamine drugs (Adderall, Dexedrine).
In 2006, the manufacturer of Dexedrine added additional warning information to its drug label. In addition to heart warnings, the label advises that this drug can worsen behavioral and psychiatric problems in patients with ADHD and accompanying psychotic or bipolar disorders. The drug may also slow growth.
The Food and Drug Administration is now requiring makers of ADHD medications to warn patients of potential heart and psychiatric risks.

ADHD Drugs and Emergency Room Visits

According to researchers from the U.S. Centers for Disease Control, more than 3,000 patients visited an emergency room in 2004 for treatment of side effects associated with ADHD medication. The researchers reported that these adverse events were due to:

Unintentional ingestion or overdose (61%)
Side effects including heart symptoms such as chest pain, high blood pressure, irregular heart beat (33%)
Allergic reactions (6%)

Most of these incidents occurred in male patients younger than 18 years old. Another 2006 study indicated that non-medical misuse of ADHD medication may account for a large percentage of these emergency room visits.

ADHD Drugs for Preschoolers?

The first long-term study to evaluate the safety and effectiveness of ADHD drugs for preschoolers indicated that these drugs may benefit some children. However, the Preschool ADHD Treatment Study (PATS) also suggested that these drugs carry serious risks, especially for slowing growth and reducing weight gain. The researchers recommend that doctors seriously consider the risks versus benefits before prescribing ADHD medication to children ages 3 – 5 years. Children who do receive medication should be carefully monitored.

Review Date: 12/21/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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