Sudden deaths in children may have link to stimulants

Children and teens who are using stimulant medications may have slightly greater risk of sudden unexplained death, according to research online in The American Journal of Psychiatry.

Results of the case-control study showed that of 564 children and teens (age 7 to 19) who had sudden deaths, 1.8% were using stimulants, higher than the 0.4% who were taking the same drugs among the controls who died in car accidents, according to researchers.

Stimulants used, according to parent interviews, medical examiner records and other sources, included amphetamine, dextroamphetamine, methamphetamine, or methylphenidate. Of the children who died suddenly, they were seven-fold more likely to be using stimulants, compared to the controls. For the 10 sudden deaths where stimulants were used, all were linked to use of methylphenidate.

One limitation of the study was that there was not ample evidence to tell whether children on stimulants had attention deficit hyperactivity disorder, although the majority of children taking stimulants have been prescribed them for management of ADHD, according to co-author Mark Olfson, MD, MPH.

FDA's adverse event reporting system documented 11 sudden deaths from 1995 to 2005 in pediatric patients who had been prescribed methylphenidate (Ritalin and others).

In related news, FDA is currently involved in two ongoing trials, one of which involves children. The trial looks at cardiovascular risk in patients using stimulants. Results may be expected as soon as later this year.

Study authors reported potential conflicts of interest with AstraZeneca, Pfizer, Eli Lilly, Janssen, Johnson & Johnson, Otsuka, and Forest.