It’s all over the media. The Amercian Heart Assocation (AHA) is now recommening routine EKG’s for all children starting or taking stimulant medications for ADHD. The information comes from a recent publication in Circulation, the journal of the AHA. The article cites cases of negative cardiac events associated with the use of stimulant medications in children. The lead author is a pediatric cardiologist of Children’s hospital in Philadelphia.

This a confusing topic for parents and clinicians alike since these new AHA recommendations contradict the ADHD Treatment Guidelines previously published by the American Academy of Child and Adolescent Psychiatry (AACAP) which Do Not recommend routine EKG’s. Typically routine EKG’s have not been recommended prior to starting ADHD medications since there is not a clearly defined link between stimulant medications and increased heart risks. It seems the experts cannot agree, so what should you do?

Know that the EKG, or Electrocardiogram, is a test that can be easily done in an office setting. Sticky pads, which are the sensors, are placed on a patients chest and attached by thin wires to a machine that monitors a patients heart beat. The test is a simple, non-invasive procedure and can be completed in 15 minutes. Many hospitals are adding this step prior to dispensing stimulant medications for ADHD.

Talk to your doctor regarding his or her policy on these new AHA recommendations. Many doctors are not in agreement with ordering EKG’s which can often frighten families away from getting needed treatments. It will be interesting to see if AACAP adapts their own ADHD Treatment guidelines to be in sync with these new guidlines from the AHA.

To avoid further confusion, it is extremely important to have a consensus reached among leading organizations such as the AACAP, AAP, and the AHA. Meanwhile if your child is on stimulant medications, make sure your doctor at minimum takes a careful cardiac history of your family and checks blood pressure and heart rate on each and every follow up visit.

Can your doctor personalize drug therapy? How far into the future will it be before doctors use genetic testing to personalize drug choices? Ten years? Twenty years? How about – today.

As of December 2007 the FDA now requires recommendations to genetically test patients of Asian decent before prescribing a drug called Tegretol, used to treat Bipolar Disorder and epilepsy. There is a greater risk for these patients to develop a potentially fatal skin rash on Tegretol if they carry a particular “HLA” gene. If patients of Asian ancestry test positive for that HLA gene they should not take Tegretol (generic name carbamazepine). For those of you wondering if you are accidentally reading a SciFi blog, the announcement for the Tegretol labeling change is posted on www.fda.gov/cdrug/infosheets/HCP/carbamazepineHCP.htm