ADHD: Commonly diagnosed disorder in children. Study links childhood deaths and stimulants

director of the Office of Drug Evaluation at the Center for Drug Evaluation and Research at the FDA, said that the study had been well conducted, but that he was concerned that not all parents may accurately recall whether children who died were taking stimulant drugs. When a child dies suddenly, he said, it is natural for a parent to pay close attention to all the medications the child was taking at the time and to report that to researchers. By contrast, he said, parents whose children die in traffic accidents may be less likely to note whether their children are taking medications — and less able to report it years later.

In an editorial accompanying the study, Benedetto Vitiello of the National Institute of Mental Health said that ADHD itself might have increased the risk for sudden, unexplained death. If that were the case, he said, it would explain why more children taking stimulant drugs found in the group that unexpectedly died than among the children who died in traffic accidents.

The researchers who conducted the peer-reviewed study acknowledged that its design precluded definitive answers, but they said that they had taken care to eliminate each of these potential confounders. They did not consider cases of sudden death in which children had asthma or cardiac abnormalities — conditions known to be associated with ADHD — because those factors might have independently raised the risk of sudden death. They also included one child who died in a traffic accident who seemed to have been abusing amphetamines, rather than taking an ADHD medication.

In a press briefing called on short notice yesterday, FDA officials said that given the seriousness of ADHD and the rarity of sudden death  Which strikes fewer than 1 in 10,000 children ? the benefits of the drugs outweigh their risks. Agency officials urged parents to discuss concerns with doctors rather than deciding on their own to discontinue a child’s Medication.

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