The Elisabeth d'Ornano Association for ADHD

Abstract:

Objective: The authors sought to determine whether there existed a significant association between the use of stimulants and the rare episodes of sudden unexplained death occurring in children and adolescents.

Method: A case-control study in which mortality data were analyzed in the period between 1985 and 1996, taken from archives of state statistics in the U.S.A. In this manner, they identified 564 cases of sudden death occurring in children and adolescents between 7- and 19-years-old in the U.S.A, which were compared with a group comparable in age and sex constituted by young people who died as passengers in traffic accidents. The principal variable evaluated was the presence of amphetamine, dextro-amphetamine, meta-amphetamine or methylphenidate, according to information from relatives or annotations appearing in medical records, toxicology results or death certificates.

Results: In 10 of the sudden unexplained death cases (1.8%), the young people were taking stimulants, specifically methylphenidate, unlike the traffic accident cases in which only 2 subjects (0.4%) were taking stimulants, of which only 1 was methylphenidate.

Per the first analysis, an association emerges between the use of stimulants and sudden unexplained death, based on an exact conditional logistic regression (Odds Ratio = 7.4, 95% CI = 1,4-74,9). An extensive series of sensitivity analysis yielded similar results.

Conclusions: This case-control study suggests the association between the use of stimulants and the sudden unexplained death in children and adolescents. Although sudden unexplained death is a very rare event, these results should be considered in the context of other data about the risk and the benefit of the use of stimulants in medical treatment.