Cardiovascular Effects of Stimulant and Non-Stimulant Medication for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of Trials of Methylphenidate, Amphetamines and Atomoxetine

AbstractBackgroundMany children and adolescents with attention deficit/hyperactivity disorder (ADHD) are treated with stimulant and non-stimulant medication. ADHD medication may be associated with cardiovascular effects. It is important to identify whether mean group effects translate into clinically relevant increases for some individual patients, and/or increase the risk for serious cardiovascular adverse events such as stroke or sudden death.ObjectivesTo evaluate potential cardiovascular effects of these treatments, we conducted a systematic review and meta-analysis of the effects of methylphenidate (MPH), amphetamines (AMP), and atomoxetine (ATX) on diastolic and systolic blood pressure (DBP, SBP) and heart rate (HR) in children and adolescents with ADHD.MethodsWe conducted systematic searches in electronic databases (PsychINFO, EMBASE and Medline) to identify published trials which involved individuals who were (i) diagnosed with ADHD and were aged between 0 –18 years; (ii) treated with MPH, AMP or ATX and (iii) had their DBP and SBP and/or HR measured at baseline (pre) and the endpoint (post) of the study treatment. Studies with an open-label design or a double-blind randomised control design of any duration were included. Statistical analysis invol ved calculating differences between pre- and post-treatment measurements for the various cardiovascular parameters divided by the pooled standard deviation. Further, we assessed the percentage of clinically releva...
Source: CNS Drugs - Category: Neurology Source Type: research

Related Links:

In this study, the trends of risk factors and macrovascular complications were examined in patients with DM in Taiwan.MethodsHealth care information and International Classification of Diseases, Ninth Revision diagnostic codes were retrieved from the Taiwan Bureau of National Health Insurance claims files between 2005 and 2014. Using these data, the number of cases and annual prevalence of diabetic macrovascular complications in individuals with DM were stratified by age and sex.ResultsThe prevalence of DM with either stroke or cardiovascular disease (CVD) showed a decreasing trend in enrolled patients with DM (p for trend 
Source: Journal of the Formosan Medical Association - Category: General Medicine Source Type: research
Source: BMJ - Category: General Medicine Source Type: research
ConclusionsThe key determinants of the Bleeding Ratio among anticoagulated AF patients are age, prior thromboembolic and bleeding episodes. The study could support identification of AF patients who need additional effort to increase their acceptance of a life-long OAC therapy.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
ConclusionCRS is associated with an increased incidence of asthma, AMI, stroke, anxiety disorder, and depression. Therefore, we suggest that clinicians should monitor CRS patients carefully, and optimize management as a means to potentially decrease these other associated comorbid conditions.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
A single daily pill containing low doses of common medications might provide a simple, inexpensive way to reduce risks for heart attacks and stroke in underprivileged communities, researchers say.
Source: Reuters: Health - Category: Consumer Health News Tags: healthNews Source Type: news
We present a case demonstrating histopathological clot findings after endovascular thrombectomy for acute ischaemic stroke in a 38 year-old male with systemic lupus erythematosus and antiphospholipid syndrome (APS). The differential diagnosis was embolism of a suspected Libman-Sacks vegetation or less likely an in-situ thrombosis. Clot analysis provided guidance with patient management and anticoagulation was commenced. The utility of clot analysis in this case provides support for routine clot analysis, which has been standard practice at our institution, and is likely to evolve as endovascular thrombectomy becomes more widely accessible.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
A selective peroxisome proliferator-activated receptor-γ agonist benefited propionic acid induced autism-like behavioral phenotypes in rats by attenuation of neuroinflammation and oxidative stress. Chem Biol Interact. 2019 Sep 25;311:108758 Authors: Mirza R, Sharma B Abstract Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in children. It is diagnosed by two main behavioral phenotypes i.e. social-communication impairments and repetitive behavior. ASD is complex disorder with unsolved etiology due to multiple genes involvement, epigenetic mechanism and environmental factors. The c...
Source: Chemico-Biological Interactions - Category: Molecular Biology Authors: Tags: Chem Biol Interact Source Type: research
AbstractThis meta-analysis was conducted to evaluate the association between Attention deficit hyperactivity disorder (ADHD) medications and risk of sudden death/arrhythmia, stroke, myocardial infarction as well as all-cause death. We searched PubMed, Web of Science and China National Knowledge Infrastructure from 1950 to May 2018. All observational studies that the exposure of interest was ADHD medications, the outcome of interest was sudden death/arrhythmia, stroke, myocardial infarction as well as all-cause death, and the study reported relative risks (RRs) with 95% confidence intervals (95% CIs) were included. Pooled R...
Source: European Child and Adolescent Psychiatry - Category: Psychiatry Source Type: research
Conclusion. Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple scleros...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research
Findings from a study published in BMJ Open Access shows that some children and adolescents who are receiving methylphenidate for treatment of attention-deficit/hyperactivity disorder (ADHD) may be at increased risk for certain adverse cardiovascular events. "Drugs to treat ADHD have been shown to be efficacious in reducing symptoms of impulsivity and hyperactivity in children,” the study authors wrote, "but concerns have been expressed about possible adverse cardiovascular events with the first-line treatment, methylphenidate."To determine whether an association exists between methylphenidate and adve...
Source: Psychiatr News - Category: Psychiatry Tags: ADHD cardiovascular risk methylphenidate youth Source Type: research
More News: ADHD | Arrhythmia | Boys | Cardiology | Cardiovascular | Children | Clinical Trials | Concerta | Databases & Libraries | Heart | Hyperactivity | Methylphenidate | Neurology | Pediatrics | Ritalin | Statistics | Strattera | Stroke | Study