Beta blockers and trouble in school?

Hi everyone! I have twin boys (fraternal) who are 9 years old. One son is LQT with Bradycardia (N), the other is borderline LQT (M). They were diagnosed after our pediatrician heard a heart murmur in N and sent us for a simple EKG. Both boys were placed on beta blockers (Nadolol). N had a lot of trouble with the medication and had just about every side effect listed while the other had no side effects at all. N had his dosage adjusted and is doing better finally. (At our last appt 2 weeks ago M had a 'normal' EKG. Yeah!)

My question is, N has started having trouble in school since being on the medication. He's had trouble concentrating and keeping up with his work. His teacher said he does not seem tired at all, just has trouble concentrating and keeping up. I had thought about having him tested for ADD, but she said he had no trouble at the beginning of the school year, so she doubts that is his problem. Has anyone ever run into anything like this with beta blockers? I am wondering if it is because of his Bradycardia.

I appreciate everything I have learned here! Thank you for such a great resource!
Tracy

By stevie13wonder
Posted June 2, 2008 at 11:02 am
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Hi,
I think that concentration problems are a common side effect with beta blockers. Some people have to try several before they find one without side effects. One that is used in children with minimal side effects is Atenolol. I would be cautious about an ADD diagnosis as many of those medications used to treat ADD can make Long QT worse. Since his ADD seemed to come about after the start of beta blockers I would maybe try a change in medication first. Talk to your son's doctor about it.

By dmwillden
Posted June 3, 2008 at 1:26 am
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Hello mom2twinz,

Yes!! Our son (14 years) had the same problem! He was diagnosed genetically positive for LQT2 after a seizure 1 1/2 years ago, but has had no symptoms since. At first we put him on Atenolol, which caused depression and agression. Then we tried Nadolol, at half the minimum dose and slowly worked up to 20 mg. I was told that any side affects would dissapear after a month or two. It seemed to work great at first, but over time he gradually and almost imperceptably started to loose the ability to concentrate in school. This was very unusual for him so we immediately suspected the medication, but I didn't realize how bad it was until he started failing some classes and getting depressed as well. He decided to not take it for a couple of day (without me knowing it) and he was so much more focused and happy--then I asked him about it and he confessed. So...I did some research on it and did find that loosing focus or, as I call it, "Aquired ADD", is a side affect, and that with this medication some of the side effects come on very gradually and imperceptibly. We have ADD issues with others in our family and it's a difficult, disabling challange. After weighing the "risk vs. cost" factors in our case and talking to our doctor, we have actually discontinued the Nadolol and are agressively researching some other interventions. (He is one of four of our children that have been tested possitive so far, so he's the "guinea pig".) As I've researched and consultied with some experts, I have found some very hopeful, natural alternative treatments that are scientifically backed, but not necessarily extensively studied.

We have LQT2, so we know that potassium, and magnesium can be helpful. I've also discovered some studies that indicate some benefits of DHA (from Omega 3), moderate exercise, and decreasing stress and/or stress reaction (i.e. meditation). I've also been advised that adaquate sleep is important, as well as decreasing salts (they dilute the potassium in the blood), and increasing water intake to maintain electrolyte levels, especially when sick and/or hot.

I hope you and your doctor can find some solutions for your son. In my case, I had to decide whether the "cure" was worse than the disease...especially since the "cure" was not a real sure thing anyway (especially for LQT2). I'm still looking and hopeful for other future medications and open to the possibility of "LCSD" (nerve surgery), but for now, we're taking one day at a time and doing what we feel is best with the options we have.

By Nessa
Posted June 4, 2008 at 1:53 pm
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My son is 23 and been on nadalol for 13 years, has depression, aniety, add and now they think he could have sleep apena, so frustrating, he can:t take any meds for add and on 2 meds for depression, aniety, but really has no choice with meds because of LQT, its soooo frustrating, only works 2 days week, in therapy, lot of depression is from having LQT not being in sports, might die always in his mind. Now just 2 days ago new therapist suggest he might have sleep apena, taht made him feel even worse. We had a distant cousin 9 years old suddenly die in sleep, this is when we were all tested 2 of my 3 have it. Please don"t just go by ekgs as in both my 2 who have it they had normal ekgs, they had stress test and halter monitor which both showed it, so I really dislike when someone says have ekg done, because it does not show it all the time, thank god my kids had more testing done. Just because ekg is normal please have further testing to rule it out.

By momo3hods
Posted June 5, 2008 at 7:53 am
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I have never heard of borderline LQT. Either you have it or you don't. Please get another opinion on this or have your kids genetically tested. Also, stay on top of the medicines effects and try other brands, and talk to your doctor about all of this...

By ncz727
Posted June 5, 2008 at 9:32 am
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Hi mom2twinz, my 9 year old daughter was diagnosed with Long QT two years ago, and placed on Atenolol. She also has trouble in school, and has recently been diagnosed with a learning disability. Some research shows that up to 1/3 of all children with heart conditions also have some sort of learning disability. My daughter had trouble in school before she started taking Atenolol, so I know it's not the medicine. My recommendation to you, besides seeing an Electrophysiologist - not a pediatrician - is to also have your children tested for any learning disabilities - the younger they start getting help for their learning disability, the better they will do in the long run. Good Luck.

By mom2twinz
Posted June 28, 2008 at 11:13 pm
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Thank you everyone for your input! In my haste I guess I didn't give all the details of my sons treatments. We do see a pediatric cardiologist at Children's Hospital of Philadelphia and also an electrophysiologist. Both boys have had several EKG's (4), Holter Monitors (3/2), and stress tests (2). N seemed to have a lot of trouble toward the end of the school year. We had tests done with the special ed teacher and she found no major problems but made suggestions for next fall when school starts as she feels it must be a side effect of his medication. Thankfully my two go to a small Christian school where the teachers are happy to make adjustments for children who have trouble.

By zackenna
Posted July 1, 2008 at 6:39 am
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Hi mom2twinz,

My son was recently diagnosed with borderline long qt and long qt. Same story....we went to rule out a hear murmur at CHOP and the Doctor found the borderline qt. After wearing the haltar monitor and exercise stress test, he has now referrred us to an electrophysiologist at CHOP as well. Our stories are very similar and I am not sure of rules of this website, but I would like to talk to you, if you do not mind. We have our appointment Thursday 7/3/08 with the electrophysiologist. Very curious, since this is all so new and confusing.

By orlandparktodd
Posted July 22, 2008 at 10:23 pm
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My daughters had everything you can think of onbetas. I was tried on betas because of blood pressure problems and in three days had a severe asthma attack, my only one ever.
Really get to know your whole extended family's medical history and reaction history as far back as you can. talk to older relatives about their relatives to fin out if anyone died suddenly, was prone to seizures or fainting. o need to become a detective and work out the kinks of the situation with your doctors.

By campingbabe4eva
Posted July 23, 2008 at 4:51 pm
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Sorry to reply so late after the post.

My 9yo daughter was on beta blockers and almost failed the school year. I finally had to take her off of them. She was absolutely exhausted all the time. She couldn't concentrate and was losing her assignments and books etc constantly.

She has an ICD now but I never regretted taking her off the meds. She was on Betaxolol, and it was not only the smallest dose but it had the least side effects.

I would definitely discuss this with her cardiologist or EP - whoever is controlling the medicine situation. Good luck.

By mom2twinz
Posted October 13, 2008 at 9:10 am
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Thank you everyone! An update...we do know that LQT is on my side of the family. My mother's brother has it as does his son (testing his sons as we speak). My son is still having trouble keeping up with work in school, but his teacher is kind enough to send his unfinished work home without penalty. They are very understanding and quick to find out what they can do to help him. We are very grateful. We will discuss the medication with the cardiologist at our next appointment. I appreciate everyone's input! Thank you for being there for us! :)

By Laylabug
Posted November 8, 2008 at 7:04 am
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Hello Mom2twinz! I am an adovcate that works with families who deal with ADD/ADHD, but I am also the mother to 2 adult children, one diagnosed with ADD and the other with ADHD. My son has ADHD and is on a stimulant medication. He has also complained about a rapid & irregular heart rate. His psychiatrist (son is in college) detected what he thought was a heart murmur and sent him for an EKG. The EKG was determined to be normal. We were all quite relieved...however...the more I learn on this site, the more fearful I become that they may have missed something.

Originally, I came to this site because I am working with a student who is 16 y/o, has ADD, is unable to take stimulant medication since discovering he has LQTS after having chest pain. He stimulant was discontinued and he was started on a beta blocker. He is now failing school. In addition to the untreated ADD, the beta blocker seems to be making him very drowsy. I need to help the school understand that his behavior is not "wilful," rather a side effect of untreated ADD and the side effect of a beta blocker.

So, the first thing I believe I need to do (ASAP) is have my son seen by a cardiologist & perhaps suggest a 24 hour monitor?? If you or anyone else has further suggestions or recommendations as to the next step, I'd sincerely appreciate your guidance.

Also, it sounds like I should suggest to the family I am working with that they should speak with thier doctor about changing medications.

I am wondering if anyone has ever had the school provide accommodations for their child because of the side effects of beta blockers. When I say, "accommodations," I mean extra help staying awake, staying focused, getting work done and turned in, etc.

My son has done very well academically since starting medication for ADHD at the age of 6 (very hyperactive and inattentive). He is now a 4th year engineering student. He still requires medication to help him focus and calm down. I can't imagine life without the benefit of stimulants to reduce ADHD symptoms. However, I can clearly see that we may be facing a delimma.

I have been working with families who deal with ADD/ADHD for many years and have never worked with, nor read about what happens when a child/adult
cannot take stimulants to due LQTS.

I want to thank everyone on this site. Your combined shared concerns and comments have prompted me to look into this syndome regarding its impact on learning and general health risks.
Thanks so much!

Welcome to Inspire!

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