Doctors get conflicting advice on ADHD drug

After analyzing safety data for Adderall, U.S. physicians are opting to continue to prescribe it, albeit with necessary cautions.

By Susan J. Landers, AMNews staff. March 7, 2005.

Washington -- Early last month, doctors were left scratching their heads about conflicting decisions by the United States and Canada about the safety of the compound amphetamine Adderall, a popular treatment for attention-deficit/hyperactivity disorder.

A review of safety data, which included several instances of sudden unexplained deaths among children who took the drug, led Health Canada to suspend sales Feb. 9 of Adderall XR, the drug's long-acting form and the only version sold in that country.

But a review of the same data led the U.S. Food and Drug Administration to strengthen warnings last August that patients with underlying heart defects might be at increased risk for sudden death from the drug.

Those disparate actions caused initial confusion among physicians in the United States who have been writing millions of prescriptions for Adderall and achieving good treatment results since the drug became available in 1999.

"The general clinical consensus in this country is that these medications are safe and well-tolerated," said David Fassler, MD, clinical associate professor of psychiatry at the University of Vermont College of Medicine. "Certainly we will continue to review any and all data that become available. But at this point, if kids are taking these medications and they are stable and responding well, we don't see any immediate reason to make a switch," he added.

But the controversy triggered concern among some pediatricians who began calling Adelaide Robb, MD, medical director of inpatient psychiatry at Children's National Medical Center in Washington, D.C. They were asking how to monitor young patients taking Adderall.