{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:31:09Z","timestamp":1767648669076,"version":"3.40.5"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,7,1]]},"abstract":"<jats:p>OBJECTIVES: Safety concerns about central nervous system stimulants for the treatment of attention-deficit\/hyperactivity disorder (ADHD) include adverse cardiac effects. This study aimed to compare the risk for cardiac events in users of methylphenidate and amphetamine salts.<\/jats:p>\n               <jats:p>METHODS: A retrospective cohort design using claims data from the Florida Medicaid fee-for-service program representing a total of 2131953 children and adolescents was used. The analysis included all beneficiaries who were between 3 and 20 years of age, enrolled between July 1994 and June 2004, had at least 1 physician diagnosis of ADHD and were newly started on methylphenidate or amphetamine salts. Each month of follow-up was classified according to stimulant use into current use or former use. We defined cardiac events as first emergency department (ED) visit for cardiac disease or symptoms. Risk between current users of methylphenidate versus amphetamine salts and former users of drugs in these categories was compared by using a time-dependent Cox proportional hazard model that adjusted for differences in gender; race; age; year of the index date; disability; congenital anomalies; history of circulatory disease; history of hospital admission; and use of antidepressants, antipsychotics, and bronchodilators.<\/jats:p>\n               <jats:p>RESULTS: A total of 456 youth visited the ED for cardiac reasons during 52783 years of follow-up. After adjustment for differences in covariates, the risk for cardiac ED visits was similar among current users of methylphenidate or amphetamines. Periods of former use had a similar risk between youth with an exposure history to methylphenidate or amphetamine.<\/jats:p>\n               <jats:p>CONCLUSION: Exposure to methylphenidate and amphetamines salts showed similar risk for cardiac ED visits. Additional population-based studies that address manifestation of serious heart disease, especially after long-term use, dosage comparisons, and interactions with preexisting cardiac risk factors are needed to inform psychiatric treatment decisions.<\/jats:p>","DOI":"10.1542\/peds.2008-3138","type":"journal-article","created":{"date-parts":[[2009,6,29]],"date-time":"2009-06-29T15:18:44Z","timestamp":1246288724000},"page":"e75-e80","source":"Crossref","is-referenced-by-count":47,"title":["Cardiac Safety of Methylphenidate Versus Amphetamine Salts in the Treatment of ADHD"],"prefix":"10.1542","volume":"124","author":[{"given":"Almut Gertrud","family":"Winterstein","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy"},{"name":"Department of Epidemiology and Biostatistics, College of Public Health and Health Professions"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Gerhard","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, and Center for Education and Research on Mental Health Therapeutics, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Shuster","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Health Policy, General Clinical Research Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arwa","family":"Saidi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,7,1]]},"reference":[{"key":"2021120902484415500_R1","unstructured":"US Food and Drug Administration. 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Long-term cardiovascular effects of mixed amphetamine salts extended release in adults with ADHD. CNS Spectr.\u20082005;10(12 Suppl 20):35\u201343","DOI":"10.1017\/S109285290000242X"},{"key":"2021120902484415500_R5","doi-asserted-by":"crossref","unstructured":"Findling RL, Biederman J, Wilens TE, et al. Short- and long-term cardiovascular effects of mixed amphetamine salts extended release in children. J Pediatr.\u20082005;147(3):348\u2013354","DOI":"10.1016\/j.jpeds.2005.03.014"},{"key":"2021120902484415500_R6","doi-asserted-by":"crossref","unstructured":"Winterstein AG, Gerhard T, Shuster J, Johnson M, Zito JM, Saidi A. Cardiac safety of central nervous system stimulants in children and adolescents with attention-deficit\/hyperactivity disorder. Pediatrics.\u20082007;120(6). Available at: www.pediatrics.org\/cgi\/content\/full\/120\/6\/e1494","DOI":"10.1542\/peds.2007-0675"},{"key":"2021120902484415500_R7","doi-asserted-by":"crossref","unstructured":"King S, Griffin S, Hodges Z, et al. A systematic review and economic model of the effectiveness and cost-effectiveness of methylphenidate, dexamfetamine and atomoxetine for the treatment of attention deficit hyperactivity disorder in children and adolescents. Health Technol Assess.\u20082006;10(23):iii\u2013iv, xiii\u2013146","DOI":"10.3310\/hta10230"},{"key":"2021120902484415500_R8","unstructured":"Gelperin K, Brinker AD, Avigan MI. MedWatch Reporting of Death, Sudden Death, and Cardiovascular Events in Association With Stimulants Used in the Treatment of ADHD Over a Recent 5-Year Period. 2006 FDA Science Forum. Available at: www.cfsan.fda.gov\/\u223cfrf\/forum06\/I-04.htm. 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