Atrioventricular nodal re-entrant tachycardia associated with stimulant treatment

A 13-year-old African-American female taking sertraline for obsessive compu lsive disorder was diagnosed with her first episode of atrioventricular (AV ) nodal re-entrant tachycardia five days after beginning Mixed Salts of a S ingle-Entity Amphetamine Product (Adderall) for treatment of attention-defi cit hyperactivity disorder (ADHD). She received successful cardioversion wi th 6 mg of intravenous adenosine, but developed a second episode of possibl e AV nodal re-entrant tachycardia twelve days after Adderall was reinitiate d at half the previous dose. The patient had clinically similar cardiac epi sodes five and six months after treatment was changed to slow-release methy lphenidate, Stimulant medication may evoke onset of AV nodal tachyarrhythmi as in patients who have the potential to develop them, possibly in combinat ion with a selective serotonergic reuptake inhibitor (SSRI).