POSITION PAPER Cardiac risk assessment before the use of stimulant medications in chil- dren and youth: A joint position statement by the Canadian Paediatric

Regulatory decisions and scientific statements regard-ing the management of Attention Deficit and Hyperactivity Disorder (ADHD) raise questions about the safety of med-ications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or func-tional heart disease. The present paper reviews the avail-able data, including peer reviewed literature, data from the United States Food and Drug Administration website on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Pediatric Society, Canadian Cardiovascular Society and the Canadian Academy of Child an