Wilens Timothy E, Prince Jefferson B, Spencer Thomas J, Biederman Joseph
Clinical Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Pediatrics. 2006 Sep;118(3):1215-9. doi: 10.1542/peds.2006-0942.
Recently, a US Food and Drug Administration advisory committee raised concerns about cardiovascular risks and sudden death in children and adolescents with attention-deficit/hyperactivity disorder who are receiving stimulants.
We comment on the risk of sudden death in children/adolescents taking stimulants compared with population rates, biological plausibility, and known cardiovascular effects of stimulants to determine specific risk.
There does not seem to be higher risk of sudden death in stimulant-treated individuals compared with the general population. Although there is evidence of biological plausibility, the known effects of the stimulants on cardiovascular electrophysiology and vital signs seem to be benign.
There does not seem to be compelling findings of a medication-specific risk necessitating changes in our stimulant treatment of children and adolescents with attention-deficit/hyperactivity disorder. The use of existing guidelines on the use of stimulants (and psychotropic agents) may identify children, adolescents, and adults who are vulnerable to sudden death.
最近，美国食品药品监督管理局的一个咨询委员会对正在接受兴奋剂治疗的注意力缺陷/多动障碍儿童和青少年的心血管风险及猝死问题表示担忧。
我们将服用兴奋剂的儿童/青少年的猝死风险与总体人群发生率、生物学合理性以及兴奋剂已知的心血管效应进行比较，以确定具体风险。
与普通人群相比，接受兴奋剂治疗的个体似乎不存在更高的猝死风险。虽然有生物学合理性的证据，但兴奋剂对心血管电生理和生命体征的已知影响似乎是良性的。
似乎没有确凿的证据表明存在特定药物风险，因此无需改变我们对患有注意力缺陷/多动障碍的儿童和青少年的兴奋剂治疗方案。使用现有的兴奋剂（和精神药物）使用指南可能会识别出易发生猝死的儿童、青少年和成年人。
