Opinion: Re-examining Ritalin

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It’s been interesting to watch the slowly developing concerns about Ritalin and other stimulants used to help children with attention deficit hyperactivity disorder (ADHD). After a few reports of sudden deaths among children taking the drugs, the Food and Drug Administration asked drug manufacturers in 2007 to include better warnings with the medications. Now a new study is out that might concern some parents, although it provides no real answers for them.

The study, funded by the FDA and National Institutues of Mental Health, looked at the files on 564 children and teenagers who had died suddenly, with no real explanation for their death. They compared those files with those of an equal number of youngsters who had died in auto accidents. The findings: 10 of those in the first group had been taking Ritalin (other medications were not widely available at the time), while only two of those in the control group had been.

It sounds frightening at first glance-- five times as many? But the children taking Ritalin made up a small portion of either group, and sudden unexplained death is itself an extremely rare occurrence among children and teens. There were other possible factors the researchers couldn’t account for. For example, teenagers with ADHD are more likely to experiment with illegal drugs. Could it be that those drugs, rather than Ritalin, caused some or all of the deaths?

The study’s conclusion: That there is an association between stimulant use and sudden unexplained death in use. NIMH’s conclusion: It always pays to remember that correlation does not imply causality. Just because there was an association doesn’t mean that one caused the other. NIMH calls for further studies as well as better screening for heart conditions among youth. And parents are left, as always, to make the best judgment they can on whether to use these daily medications.