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Adverse Effects of α-2 Adrenergic Agonists and Stimulants in Preschool-age Attention-deficit/Hyperactivity Disorder: A Developmental-Behavioral Pediatrics Research Network Study.
Loe, Irene M; Blum, Nathan J; Shults, Justine; Barbaresi, William; Bax, Ami; Cacia, Jaclyn; Deavenport-Saman, Alexis; Friedman, Sandra; LaRosa, Angela; Mittal, Shruti; Vanderbilt, Douglas; Harstad, Elizabeth.
Afiliação
  • Loe IM; Department of Pediatrics, Stanford University, Stanford, CA. Electronic address: iloe@stanford.edu.
  • Blum NJ; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
  • Shults J; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
  • Barbaresi W; Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA.
  • Bax A; Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
  • Cacia J; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Deavenport-Saman A; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA; Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA.
  • Friedman S; Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.
  • LaRosa A; Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
  • Mittal S; Department of Pediatrics, Atrium Health, Concord, NC.
  • Vanderbilt D; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA; Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA.
  • Harstad E; Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA.
J Pediatr ; 257: 113325, 2023 06.
Article em En | MEDLINE | ID: mdl-36649794
ABSTRACT

OBJECTIVES:

To characterize and compare the type and frequency of a range of common and uncommon adverse effects (AEs) associated with α-2 adrenergic agonist (A2A) and stimulant treatment of attention-deficit/hyperactivity disorder at preschool-age as well as to evaluate the impact of age on common AEs. STUDY

DESIGN:

This was a retrospective electronic medical record review of children <72 months of age (n = 497) evaluated at outpatient developmental-behavioral pediatric practices at 7 US academic medical centers within the Developmental-Behavioral Pediatrics Research Network. Data on AEs were abstracted for children who had treatment initiated by a developmental-behavioral pediatrician with an A2A or stimulant medication between January 2013 and July 2017; follow-up was complete by February 2019.

RESULTS:

A2A and stimulants had distinctive AE profiles. A2A compared with stimulants had a greater proportion with daytime sleepiness and headaches; stimulants had significantly greater proportions for most other AE, including moodiness/irritability, difficulty with sleep, appetite suppression, stomachaches, skin picking/repetitive behaviors, withdrawn behavior, and weight loss. Younger age was associated with disruptive behavior and difficulty with sleep.

CONCLUSIONS:

Stimulants had a greater rate of most AEs compared with A2A. AE profiles, together with efficacy, should inform clinical decision-making. Prospective randomized clinical trials are needed to fully compare efficacy and AE profiles of A2A and stimulants.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pediatria / Transtorno do Deficit de Atenção com Hiperatividade / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos / Estimulantes do Sistema Nervoso Central Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pediatria / Transtorno do Deficit de Atenção com Hiperatividade / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos / Estimulantes do Sistema Nervoso Central Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article