A panel of the federal Food and Drug Administration this month recommended the makers of Ritalin add warnings to its label. But a University of Iowa child psychiatrist says there needs to be more research on the impact of the drug. The suggested new warning would tell users about deaths from heart attacks among people using the stimulant drug.

Doctor Sam Kuperman says there’s not enough known about the link between the drug and the deaths. The doctor points out the latest report finds 25 deaths among four-Million prescriptions for the drug. “Obviously, if you’re one of the 25 affected,” Kuperman says, “It’s a meaningful number to you.” But not all those 25 deaths have been positively attributed to the use of stimulants, and he says they need to do more research on the connection.

Kuperman says each case is different and you can review your child’s use of the drug if you’re worried. If you have concerns about the use of the medication in a child, you should talk to your doctor about why they’re on it, and make an informed decision whether it’s the right medication to treat the symptoms they’re showing. Kuperman says, “If you do that, then you’re doing the best thing possible for your child.”

Kuperman says the stimulant has some positive effects on some kids. Often children who are hyperactive and impulsive do dangerous things anyway, he says, like climbing trees and jumping their bikes without any regard to the outcome. The doctor says kids like that can be the ones doing dangerous activities causing broken bones, cuts and bruises, so Ritalin’s useful to try and decrease accidents related to being impulsive.

Kuperman cited this example of a patient who could benefit from the drug. His favorite story’s about parents of a hyperactive kid who brought home a new refrigerator with lots of packaging. They’d thrown it out when they looked out a window to see the child with the big plastic bag, ready to jump off a shed using the plastic bag as a parachute. The father rushed out to tell him he’d get hurt and the child responded, “It worked fine the first time.”