Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents

Samuele Cortese, Martin Holtmann, Tobias Banaschewski, Jan Buitelaar, David Coghill, Marina Danckaerts, Ralf W. Dittmann, John Graham, Eric Taylor, Joseph Sergeant, European ADHD Guidelines Grp

    Research output: Contribution to journalArticlepeer-review

    254 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)227-246
    Number of pages20
    JournalJournal of Child Psychology and Psychiatry
    Volume54
    Issue number3
    DOIs
    Publication statusPublished - Mar 2013

    Keywords

    • medication
    • PHARMACOLOGICAL-TREATMENT
    • adverse events
    • ADHD
    • European
    • ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
    • TIC DISORDERS
    • SERIOUS CARDIOVASCULAR EVENTS
    • OROS METHYLPHENIDATE
    • OF-THE-LITERATURE
    • STIMULANT MEDICATIONS
    • SUBSTANCE USE DISORDERS
    • DEFICIT-HYPERACTIVITY DISORDER
    • recommendations
    • SUICIDE ATTEMPTS
    • management

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