Some ADHD drugs (stimulants) can be harmful to people with heart conditions, so doctors now screen with an EKG when prescribing them.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects people of all ages and is commonly diagnosed in childhood. An estimated 9.4% of children in the United States have an ADHD diagnosis.

ADHD is mostly known for the inability to focus, but it can bring many symptoms that interfere with your ability to function. Symptoms like hyperactivity and impulsivity can also pose challenges in your daily life.

There are many treatment options available, and medication is among the most common. Electrocardiograms (EKGs) are now part of the screening for prescribing children with ADHD medication.

The American Heart Association (AHA) has released recommendations that children undergo an EKG before starting stimulant therapy. This can help identify cardiac conditions before they take ADHD drugs, which can have adverse effects on people with heart issues.

The AHA also recommends a thorough exam, including a look at the family history, to ensure that children don’t have any undiagnosed heart problems before starting ADHD medications.

ADHD medications include stimulants and non-stimulants. Both affect neurotransmitters in the brain, but stimulants increase dopamine while non-stimulants do not. Stimulants are prescribed more often and are considered more effective for ADHD.

Common ADHD medications include:

Experts have been concerned that ADHD medications may cause heart problems for decades, but there is a scarcity of research on the long-term cardiovascular effects of stimulant drugs. Most of the research on ADHD medications is on adults.

Modest increases in blood pressure and heart rate can increase the risk of adverse cardiovascular events, and existing research suggests that ADHD medications increase both resting heart rate and systolic blood pressure. This may also decrease life expectancy.

In children, the risk of myocardial infarction and arrhythmias is increased with the use of methylphenidate, one of the most common ADHD medications, according to a 2016 study. The risk is likely to be low in general and is highest in children with congenital heart disease.

In response, doctors use regular EKG monitoring to detect heart abnormalities before and during ADHD medication use.

Doctors use EKGs to check for heart abnormalities and heart conditions. The test measures the electrical signals in your heart to detect the following:

  • arrhythmias (irregular heartbeat)
  • heart disease
  • heart attack
  • an enlarged heart
  • heart rate

The test is fast, painless, and performed outside of the body. It involves placing electrodes, which look like stickers or suction cups, on the chest. These electrodes record the heart’s electrical signals, which are displayed on a computer monitor.

A doctor can interpret the results immediately after the test to determine whether the person has normal or abnormal heart function.

If abnormalities are present, the results might affect the doctor’s choice of ADHD medication.

Medications of all kinds often come with a list of side effects. Some are unlikely to occur, but being aware of the risks can help you make an informed choice.

There is growing concern that stimulant ADHD medications increase the risk of cardiovascular events in children.

The American Heart Association recommends that children undergo EKG testing prior to starting ADHD drugs. This can help detect undiagnosed heart conditions that may further increase the risk of cardiovascular complications.

Existing research suggests that the risk is low, but more research is ultimately needed to study the long-term cardiovascular effects of stimulant use in children.

The following resources may be helpful for parents with children diagnosed with ADHD: