ADHD Drugs Tied to ER Visits

May 25, 2006 -- Doctors from the CDC estimate that more than 3,000 people visited hospital emergency departments in 2004 due to side effects from drugs to treat attention deficit hyperactivity disorder (ADHD).

The estimate -- made by the CDC's Adam Cohen, MD, MPH, and colleagues -- appears in a letter in The New England Journal of Medicine.

Cohen and colleagues reviewed database records from 64 U.S. hospitals. They counted emergency department visits linked to stimulant drugs widely prescribed for ADHD.

The database showed 81 cases in 2004. From that figure, "we estimate that 3,075 patients presented to emergency departments nationally for adverse events from stimulant drugs prescribed for the treatment of ADHD" in 2004, write Cohen and colleagues.

Their letter doesn't tie any particular ADHD drug to the cases reported in the database.

Data's Details

Cohen and colleagues checked the database's records for Aug. 1, 2003 to Dec. 31, 2005. They found 188 emergency department visits related to ADHD drugs during that time.

Of those ER trips, more than half -- 115 -- were due to accidental ingestion or overdose, and half of those visits (65) were related to the patient taking medications that were not prescribed for them. Another 73 ER visits were due to adverse effects or allergic reactions.

Twenty-six patients -- including nine who had unintentionally taken the drugs or overdosed on the medications -- had possible cardiovascular symptoms or signs such as chest pain, high blood pressure, stroke, and irregular heartbeat.

Out of all 188 adverse events, 30 required hospitalization and 36 required pumping the patients' stomach. Most of those cases were linked to inappropriate use of the drugs.

All of the patients who had their stomachs pumped had overdosed on the drugs or unintentionally taken the drugs. All but six hospitalizations were due to overdoses or accidental ingestion of the drugs.

More than eight in 10 ER trips were made by patients less than 18 years old; more than half (59%) were made by males, who outnumber females in ADHD diagnoses.

Drug Company Responds

WebMD contacted the drug company Novartis, which makes the ADHD drug Ritalin, for its comments. Novartis spokeswoman Denise Brashear e-mailed the company's response.

"Regarding emergency room visits due to overdoses and misuse of ADHD medications reported by the CDC, when used inappropriately all medications have unpredictable effects. ADHD medications should only be used as indicated under the care of a qualified physician," the statement continues.

"Ritalin, approved by the FDA in December 1955, has a long record as a safe and effective medication for the symptoms of ADHD. For more than 50 years it has helped patients and their families lead more productive, healthy lives," states Novartis.