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How do you approach stimulant prescribing for ADHD when a patient has previously reported palpitations with stimulants but has a normal EKG off medication?

3 Answers
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Psychiatry · Texas Tech Health Science Center
Answered on

Get a cardiology consult and get a certificate about stimulant safety before initiating stimulants.

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Psychiatry · Wayne State University School of Medicine
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Stimulant medications are unlikely to cause serious cardiac issues in pediatric patients without underlying heart disease; however, an EKG alone does not rule out all conditions that could contribute to a sudden cardiac event. Thus, if cardiac symptoms develop during stimulant treatment, referral to...

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Psychiatry · Thapar Renu K Office
Answered on

One time EKG is not enough to rule out a cardiac problem. If an EKG is done at the time of palpitations, it can yield more information.

One needs a Holter monitor for 3 days to one week to rule out arrhythmia. And an echocardiogram to rule out the structural and functional status of the heart.

All o...

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