Title:
Practitioner Review: Current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents
Authors:
Cortese, S; Holtmann, M; Banaschewski, T; Buitelaar, J; Coghill, D;
Danckaerts, M; Dittmann, RW; Graham, J; Taylor, E; Sergeant, J
Source:
*JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY*, 54 (3):227-246; MAR 2013
Abstract:
Background: Medication is an important element of therapeutic strategies
for ADHD. While medications for ADHD are generally well-tolerated, there
are common, although less severe, as well as rare but severe adverse
events AEs during treatment with ADHD drugs. The aim of this review is
to provide evidence- and expert-based guidance concerning the management
of (AEs) with medications for ADHD. Methods: For ease of use by
practitioners and clinicians, the article is organized in a simple
question and answer format regarding the prevalence and management of
the most common AEs. Answers were based on empirical evidence from
studies (preferably meta-analyses or systematic reviews) retrieved in
PubMed, Ovid, EMBASE and Web of Knowledge through 30 June 2012. When no
empirical evidence was available, expert consensus of the members of the
European ADHD Guidelines Group is provided. The evidence-level of the
management recommendations was based on the SIGN grading system.
Results: The review covers monitoring and management strategies of loss
of appetite and growth delay, cardiovascular risks, sleep disturbance,
tics, substance misuse/abuse, seizures, suicidal thoughts/behaviours and
psychotic symptoms. Conclusion: Most AEs during treatment with drugs for
ADHD are manageable and most of the times it is not necessary to stop
medication, so that patients with ADHD may continue to benefit from the
effectiveness of pharmacological treatment.
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