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sudden sensitivity to stimulants

): Therapie psychischer Erkrankungen, 13. 6, Journal of the Korean Academy of Child and Adolescent Psychiatry, Vol. The distribution of informants did not significantly differ by group (χ 2 =8.1, df=6, p=0.23). Conclusions: This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents. Unlike other victims of injuries (28) , motor vehicle passenger victims were selected because they have been found not to be at greater risk for hyperactivity and other deficits in vigilance, attention, and impulse control. Clin Pharmacol Ther 1999; 66:295–305Google Scholar, 17. 1, Children and Youth Services Review, Vol. Please read the entire Privacy Policy and Terms of Use. First, it employed a matched case-control design, which yielded substantial power to detect rare outcomes. N Engl J Med 1996; 334:1039–1044Google Scholar, 15. Table 2 displays the demographic characteristics of the sudden unexplained death cases included in the study and the motor vehicle accident comparison group; race and region of death significantly differed between the two groups. Parents were approached for surveys and consent for records, if required by state law. 132, No. 28, No. Antihypertensive drugs dropped my blood pressure to 40/30. There were no significant differences in gender or race between the sudden unexplained death cases included and excluded from the study. 53, No. Dr. Greenhill has received research support from Johnson & Johnson, Otsuka, and Forest. It seems the list is endless. It would normally persist for a couple of hours, gradually tapering off. So before you get to the genetic or nutritional or psychosomatic factors, first consider these. Increased Cardiac Death or Decreased Motor Vehicle Accidents? 58, No. 12, European Child & Adolescent Psychiatry, Vol. 1, Expert Opinion on Drug Safety, Vol. The odds ratio derived from the primary exact logistic regression was 7.4 (95% CI=1.4–74.9; p=0.02). Although included subjects are not representative of all sudden unexplained death cases, pairs were either matched (age, gender, and date of death) or adjusted (race and region of death) for these sociodemographic and vital characteristics. 10, Pharmacoepidemiology and Drug Safety, Vol. There have been reports of pediatric stroke after long-term use of methylphenidate within therapeutic ranges (1) . 72, No. A case-report, The FDA Reviews Safety of Stimulant Medication for ADHD, Stimulant Treatment of ADHD and Risk of Sudden Death in Children. First, while case-control studies are a powerful method of detecting association, they cannot establish causality. 8, Monatsschrift Kinderheilkunde, Vol. 33, No. 50, No. 3, 17 December 2018 | Pediatric Research, Vol. Furthermore, because ADHD (34) and impaired attention (35) are common among youths with some congenital structural cardiac diseases, we excluded individuals with evidence of cardiomegaly, cardiac hypertrophy, and cardiomyopathy. J Thoracic Cardiovascular Surgery 2005; 129:1091–1097Google Scholar, 36. Pediatr Clin North Am 2004; 51:1201–1209Google Scholar, 14. 3, European Neuropsychopharmacology, Vol. A 10-year analysis of Florida Medicaid claims data revealed that stimulant use among youths diagnosed with ADHD was associated with increases of 20% and 21% in risk of emergency department visits and physician office visits for cardiac symptoms, respectively (7) . The stress response immediately causes specific physiological, psychological, and emotional changes in the body that enhance the body's ability to deal with a threat - to either fight with or flee from it - which is the reason the stress response is often referred to as the fight or flight response. Damaged blood vessels can reduce penis sensitivity. Since a matched comparison subject was only sought after the identification of a case with appropriate documents, the interval between date of death and informant survey was significantly longer for the comparison subjects (mean=12.8 years, SD=4.5) than the sudden unexplained death cases (mean=9.8 years, SD=5.2) (t=9.5, df=252, p<0.01), suggesting a possible recall bias. The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. Zuvekas SH, Vitiello B, Norquist GS: Recent trends in stimulant medication use among US children. 2, Journal of Child and Adolescent Psychopharmacology, Vol. 15, No. Individuals who died as passengers in motor vehicle traffic accidents with another motor vehicle (ICD-9 code E812.1) were also examined. 14, No. contributing factors in stimulant dependence, reasons for over sensitivity to stimulants. 4, 31 May 2019 | Pedagogy, Culture & Society, Vol. 23, No. 2, Journal of the American Academy of Child & Adolescent Psychiatry, Vol. Second, multiple sources of information were used to increase the sensitivity of detecting stimulant use. Conclusions: This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents. Method: A matched case-control design was performed. 4, Journal of Cardiovascular Electrophysiology, Vol. While this information was occasionally noted in a medical record or by an informant, it was not available for all subjects. George AK, Kunwar AR, Awasthi A: Acute myocardial infarction in a young male on methylphenidate, bupropion, and erythromycin. 58, No. 166, No. 9, No. Take caffeine, for example. 28, No. Arch Pediatr Adolesc Med 2003; 157:17–25Google Scholar, 30. Stimulants were identified in two of the 564 motor vehicle accident comparison subjects (0.4%). Nevertheless, there may be unknown selection biases related to our inability to obtain information from all potential cases. 4, No. J Clin Psychiatry 2003; 64:1163–1169Google Scholar, 35. Manci EA, Culberson DE, Yang YM, Gardner TM, Powell R, Haynes J Jr, Shah AK, Mankad VN; Investigators of the Cooperative Study of Sickle Cell Disease: Causes of death in sickle cell disease: an autopsy study. 15, No. Threshold postmortem blood levels of detection of the targeted stimulant exposure varied by jurisdiction, raising the possibility that the thresholds for sudden unexplained death cases might be more sensitive than for the comparison group of motor vehicle accident victims. 20, Acta Psychiatrica Scandinavica, Vol. A history of sudden death among relatives was also assessed. 2, 8 July 2010 | Expert Opinion on Drug Safety, Vol. Differences in age would likely have yielded lower rates of stimulant use among those included because age is inversely related to stimulant use (26 , 28) . My mother and daughter have the same problem. and research staff, blind to medication status. 9, Expert Review of Neurotherapeutics, Vol. 85, No. 88, No. 13, No. 16, No. However, a sensitivity analysis revealed that even if 40% of sudden unexplained death cases were excluded due to undetected cardiac disease, the primary analysis would still yield a significant association. Plaza V, Serrano J, Picado C, Sanchis J; High Risk Asthma Research Group: Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma. Sensitivity analyses using alternative measures of stimulant exposure revealed qualitatively similar findings, indicating that qualitatively our finding is insensitive to the stimulant exposure algorithm. 3, Regulatory Toxicology and Pharmacology, Vol. 158, No. Results of the current study are consistent with these concerns. 26, No. In 2008, the American Heart Association recommended considering routine ECGs prior to starting children with ADHD on stimulant and other psychotropic therapy regimens (11) but underscored the need for future studies to assess the risk of sudden death associated with stimulant medication use in children and adolescents.

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