Expert: Dr Billy Levin - 8/28/2007

Question
My son was diagnosed with ADHD last spring.(he' s 10) .  He takes 5mg of
focalin XR Daily. ( just for school)  Reports from school have been better.  
How safe is this medication, concerned with the reports and new warnings
about cardiac problems(sudden death.) He had an EKG and echo before
starting meds.(normal).  He is a competive athlete baseball and football. I
guess I would love to understand what this drug does to the heart and if a
healthy child is at risk for sudden death from theses meds.  He came home
from school and said his left upper arm hurts when he plays or runs around,
my heart sunk first thing thought of was cardiac problems.  Just looking for
some piece of mind.
Thanks concerned parent
'

Answer
As ADHD is not just a morning condition treatment should be given to cover at least 12 hours of the day every day, not just school days. Focalin XL ony covers 8 hours. There should be a top-up of the short acting Focalin in the afternoon when the XL fades. It is considered a safe medication. The deaths reported on childrem on Focalin, were not caused by the medication. 5mg Focalin XL is a very small dose and might not be enough. Only an optimal dose works well. This is usually evaluated using rating scales from teacher and parent on a regular basis.