PEDIATRICS Vol. 98 No. 6 December 1996, pp. 1223-1224
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Clonidine and Electrocardiograms

JAMES A. BLACKMAN MD, MPH1, LISA SAMSON-FANG MD1, and HOWARD GUTGESELL MD2

1 Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, VA 22903
2 Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, VA 22903

Maloney and Schwam provided an example of the potential power of a letter to the editor of a major journal. By calling attention to a drug company's record of three instances of sudden death in children taking clonidine and methylphenidate concomitantly, common practice and even perceived standard of care may change. Many adults and children have been on clonidine with or without methylphenidate but have not had this dire consequence.

Reports of untoward effects of commonly used drugs are useful but recommendations for changes in care practice, especially when they involve considerable expense and anxiety for patients and parents, should be made cautiously and rationally.