ADHD medication and ECGs

[Neurotic1000]

I am incredibly confused
The private doctor who did the assessment has requested I get a private ecg ( gp won’t do it as it’s for private medication ) but can she interpret the results well enough to confirm the medication would be safe?
DH thinks as she’s not a cardiologist that this is very risky - I just want to help DS get through school life 😢

They just need to check there is nothing abnormal, and to get a baseline for future comparison.

If you get a private ECG you’ll be paying for a private report on it too.

My friend’s DD started on meds for ADHD and suffered from severe palpitations so you are being given good advice.

Yes, DD had to have an ECG before starting on methylphenidate (Concerta).

She said she could read the results which is what my DH isn’t happy about
I’m now considering if the risks outweigh the potential benefits
I feel in a complete tizz about everything

Who do you think interprets the 1000's of ECG done every day in hospitals?
Not cardiologists I can tell you that

ECG is not essential for ADHD meds unless a family history of heart problems. Loads of research out there.

DD started on them this summer. The psychiatrist listened to her heart and did other checks - very senior NHS doctor so was happy to trust that having done my own research in advance.

https://www.gehealthcare.com/insights/article/ecg-and-the-effects-of-adhd-medication-what-you-need-to-know#:~:text=Despite%20past%20concerns%20about%20ADHD,not%20suggest%20underlying%20cardiac%20disease.

There is a family history sadly
27 year old paternal aunt of DS’ died of a heart attack recently

I am really conflicted and wish someone could just make the decision for me

I had an ECG recently that my GP reviewed (and indeed my psychiatrist). No cardiologists involved. It wouldn't worry me at all.

My DC also had an ECG before starting ADHD meds due to family heart history. We had a private ADHD appointment and the consultant asked us to make an appointment with our normal GP surgery for the ECG. The ECG was reviewed by our GP and the private ADHD doctor. DC has been on meds for 3 years now

Dc had an ECG on the NHS before starting on the meds. It seemed like they were doing it for everyone in my area.

Plenty of doctors review them - including GPS.

I can see why your DH might be concerned given you’ve just experience such a young death in the family though. In which case once you’ve had it just pay for a private review from a cardiologist.

It’s so hard knowing what yo go for the best

My practice nurse does my ECG and is capable of spotting the problem that can occur.

I have had an ecg done at Gp’s and Gp looked at results

In that case I would be wanting the ECG and a consultant appointment just for peace of mind.

Plus start low dose and over a weekend so they were at home with me. Or potentially try a non stimulant firstl.

The results we've had with methylphenidate have been life changing beyond our wildest imagination, so I hope all goes well for you.

Same here

My dd recently started on ADHD medication. Prior to this the specialist requested an ECG by GP. I was also concerned if this would be ok and wanted a cardiology referral but my other dd who is a doctor said that they are only looking for certain abnormalities that all doctors should be able to identify and that there was no need for a cardiologist

There is actually research showing that people (including children) on ADHD medication have (very) slightly lower risk of heart problems than the general population.

There is no mechanism by which stimulant medication would make your heart healthier - the assumption is that it's probably more that if you check everyone who wants to take ADHD medication with an ECG before you start, then you will randomly pick up some heart problems which nobody would have noticed otherwise and those people will (first of all) not be put on the stimulant medication, but also, they'll get medical attention for their heart problem which they wouldn't have otherwise. But the important thing is to note that being on the medication does not pose an increased risk for heart problems, according to long term studies.

Basically, because it is the one thing that everyone is worried about, they check for it. It's a precaution.

You don't need a cardiologist to look at it if the result is normal. They only get a cardiologist to look at it if something looks abnormal. The GP/private doctor/whoever is qualified enough to see if it looks normal.

If there aren't any abnormalities picked up on the ECG then it is worth trying stimulant medication first - the non-stimulants are much less effective in children apparently. They are moderately effective in adults and for that case can be a first line option. But for children they should be more of a last resort if none of the stimulants are tolerated.

My dd had to have 2 ECGs taken a little while apart before being allowed to start on meds.
She had them done at her GPs.

Nurses also look at ECG results. You don't have to be a Dr, let alone a cardiologist to be able to interpret them.

Same, history here. ECG done, private psych got 2nd opinion on result as something bothered her. Now on Concerta and as others say, it’s been life changing.

An ECG isn't rocket science. It is either normal, borderline or abnormal.

All GP's are trained to use an ECG machine. In our practice the nurse does the ECG and the doctor runs an eye over the printout.

Your DH doesn't understand the way it works.

The chances of a consultant cardiologist seeing an ECG first hand are low. It would usually be flagged by GP. If the GP says it's normal, that would be good enough for me.

It is standard for ADHD medication to have a baseline ECG done.

https://geekymedics.com/how-to-read-an-ecg/

Heart attack or cardiac arrest? If the latter then you need an ECG. And an echo.

If it is a heart attack then that is incredibly rare (I came across it once in 10 years working in technical cardiology) but is not necessarily linked to arrhythmias.

@MiniBossFromAus That's actually a good site, I didn't think it would be.

And yes a GP can read an ECG.