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Does quality of life outweigh the cardiovascular risks of stimulant medication in a child with ADHD and hypertrophic cardiomyopathy?
  1. Emily Senderey1,
  2. John Sousa2,
  3. Mark Stavitsky1,2
  1. 1Department of Pediatrics, Florida Atlantic University, Boca Raton, Florida, USA
  2. 2Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, USA
  1. Correspondence to Emily Senderey, esender2{at}


A 10-year-old girl with attention-deficit hyperactivity disorder (ADHD) is diagnosed with hypertrophic cardiomyopathy. The stimulant medications used to control her ADHD pose possibly fatal risks to her cardiovascular health, so stimulant medication is stopped. Due to very poor quality of life off of medication, alternative therapies are used without improvement. The patient’s caretakers decide that the benefits of stimulant medication outweigh the risks to the patient. The healthcare team clears the patient to be put back on stimulant medication with a signed waiver of liability by her caretakers.

  • cardiovascular system
  • contraindications and precautions
  • ethics
  • medical management
  • drugs: psychiatry

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  • Handling editor Seema Biswas

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content. These authors include: ES (primary author), JS (secondary author) and MS (attending physician). Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the BMJ case reports. This case report is written about a pediatric patient of MS. The ethical dilemma in handling this patient’s care stimulated discussion among us. This lead to a thorough search for guidelines on patient management and a literature search to identify similar cases. We believed that the discussion and treatment of this patient was worthy of a publication. ES and JS wrote the case report in full disclosure with the family and doctors involved. MS mentored us through the process. There were no data collected for this submission.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained

  • Provenance and peer review Not commissioned; externally peer reviewed.