Document Detail


Sudden death and use of stimulant medications in youths.
MedLine Citation:
PMID:  19528194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors sought to determine whether a significant association exists between the use of stimulants and the rare event of sudden unexplained death in children and adolescents. METHOD: A matched case-control design was performed. Mortality data from 1985-1996 state vital statistics were used to identify 564 cases of sudden death occurring at ages 7 through 19 years across the United States along with a matched group of 564 young people who died as passengers in motor vehicle traffic accidents. The primary exposure measure was the presence of amphetamine, dextroamphetamine, methamphetamine, or methylphenidate according to informant reports or as noted in medical examiner records, toxicology results, or death certificates. RESULTS: In 10 (1.8%) of the sudden unexplained deaths it was determined that the youths were taking stimulants, specifically methylphenidate; in contrast, use of stimulants was found in only two subjects in the motor vehicle accident comparison group (0.4%), with only one involving methylphenidate use. A significant association of stimulant use with sudden unexplained death emerged from the primary analysis, which was based on exact conditional logistic regression (odds ratio=7.4, 95% CI=1.4 to 74.9). A comprehensive series of sensitivity analyses yielded qualitatively similar findings. CONCLUSIONS: This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents. Although sudden unexplained death is a rare event, this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment.
Authors:
Madelyn S Gould; B Timothy Walsh; Jimmie Lou Munfakh; Marjorie Kleinman; Naihua Duan; Mark Olfson; Laurence Greenhill; Thomas Cooper
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2009-06-15
Journal Detail:
Title:  The American journal of psychiatry     Volume:  166     ISSN:  1535-7228     ISO Abbreviation:  Am J Psychiatry     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-02     Completed Date:  2009-09-10     Revised Date:  2010-02-11    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  992-1001     Citation Subset:  AIM; IM    
Affiliation:
Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032. gouldm@childpsych.columbia.edu.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic / mortality,  statistics & numerical data
Adolescent
Adolescent Behavior / psychology
Adult
Age Distribution
Case-Control Studies
Cause of Death
Central Nervous System Stimulants / adverse effects*,  therapeutic use
Child
Coroners and Medical Examiners / statistics & numerical data
Death Certificates
Death, Sudden / epidemiology*
Dextroamphetamine / adverse effects
Female
Humans
Logistic Models
Male
Methamphetamine / adverse effects
Methylphenidate / adverse effects
Risk Factors
United States / epidemiology
Grant Support
ID/Acronym/Agency:
R01-MH56250/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 113-45-1/Methylphenidate; 51-64-9/Dextroamphetamine; 537-46-2/Methamphetamine
Comments/Corrections
Comment In:
Am J Psychiatry. 2010 Feb;167(2):213-4; author reply 214-5   [PMID:  20123922 ]
Am J Psychiatry. 2010 Feb;167(2):213; author reply 214-5   [PMID:  20123923 ]
Am J Psychiatry. 2010 Feb;167(2):214; author reply 214-5   [PMID:  20123924 ]
Am J Psychiatry. 2009 Sep;166(9):955-7   [PMID:  19528196 ]

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