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BMJ 2011; 343 doi: (Published 09 November 2011) Cite this as: BMJ 2011;343:d7193

Reassuring new safety data for ADHD drugs

Millions of children in the US and elsewhere take drugs such as methylphenidate for attention deficit hyperactivity disorder (ADHD). Could these children be risking serious cardiovascular side effects? Five years after an inconclusive review by drug regulators, a large study provides the most reassuring data so far. In a cohort of more than one million children and young adults, those taking any drug for ADHD were no more likely to have a serious cardiovascular event than anyone else, during an average follow-up of two years. Absolute risks of sudden cardiac death, heart attack, or stroke were low overall (81 events among 1 200 438 children and young adults, or 3.1 events per 100 000 person years). After extensive adjustments, the hazard ratio comparing users and non-users of these drugs was 0.75 (95% CI 0.31 to 1.85).

Researchers combined data from four major health plans in the US and ran several different analyses, all with comparable results. Drug treatments for ADHD do not seem to cause life threatening cardiovascular events, they write. Even if the “true” hazard ratio was somewhere near the upper confidence limit of 1.85, the absolute risk for any child on treatment would still be very low.

A similar study looking at the safety of treatments for ADHD in adults over the age of 23 is now on the way.

Androgen deprivation therapy isn’t enough for locally advanced prostate cancer

Androgen deprivation therapy with medical or surgical castration is not enough for men with locally advanced prostate cancer, according to a large trial. Adding radiotherapy improved overall survival, prevented deaths from prostate cancer, and helped slow progression of disease.

The 1205 men in this trial had high risk but non-metastatic prostate cancers, mostly stage T3. More than 90% were treated with a luteinising hormone …

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