Researchers from Cincinnati Children’s Hospital Medical Center have found no increased mortality or changes in cardiac vital signs among children with congenital heart disease taking attention-deficit/hyperactivity disorder (ADHD) stimulant medications. The study results will be presented at the annual meeting of the Society for Developmental and Behavioral Pediatrics in Las Vegas.

The Food and Drug Administration (FDA) currently requires labeling of stimulant medications to include a warning that they generally should not be used in children and adolescents with serious structural cardiac abnormalities, cardiomyopathy, or arrhythmias. In this study, data on 44 children aged 6–18 with congenital heart disease and taking stimulants for ADHD were compared to those with similar heart disease but not treated with stimulants. Even for children with ADHD and severe heart conditions, patients taking stimulants had significant improvements in ADHD symptoms as measured by standardized rating scales without an increased risk for death or changes in cardiac vital signs such as blood pressure or heart rate.

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Because stimulants are considered to be highly effective for treating ADHD symptoms, patient families, cardiologists, and developmental pediatricians should together weigh the risks and benefits of medication treatment options for each individual patient, according to study lead author Julia Anixt, MD. “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 Dr. Anixt.” “This study indicates that stimulants are both effective and safe when prescribed with appropriate monitoring and in collaboration with the patient’s cardiologist.”

Next steps include studying the effect of stimulant medications on ECGs.

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