EDUARDO FERRACIOLI ODA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Meta-Analysis: Reduced Risk of Anxiety with Psychostimulant Treatment in Children with Attention-Deficit/Hyperactivity Disorder(2015) COUGHLIN, Catherine G.; COHEN, Stephanie C.; MULQUEEN, Jilian M.; FERRACIOLI-ODA, Eduardo; STUCKELMAN, Zachary D.; BLOCH, Michael H.Objective: Anxiety is a commonly reported side-effect of psychostimulant treatment. Our goal was to quantify the risk of anxiety as a side effect of psychostimulant treatment for attention-deficit/hyperactivity disorder (ADHD). Methods: We conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of psychostimulant medications in the treatment of children with ADHD. We used a fixed-effects meta-analysis to examine the risk ratio of anxiety reported as a side effect in children treated with psychostimulants compared with those treated with placebo. We used stratified subgroup analysis and meta-regression to examine the effects of stimulant type, dosage, duration of use, and trial design on the measured risk of anxiety. Results: We identified 23 studies involving 2959 children with ADHD for inclusion in our meta-analysis. The risk of anxiety associated with psychostimulant treatment was significantly lower than that experienced with placebo (relative risk [RR]=0.86 [95% CI: 0.77, 0.95], z=-2.90, p<0.05). Higher doses of psychostimulants were associated with a reduced measured risk of anxiety of psychostimulants when compared with placebo (=-0.0039 [95% CI: -0.00718, -0.00064], z=-2.34, p=0.019). Conclusions: Meta-analysis suggests that treatment with psychostimulants significantly reduced the risk of anxiety when compared with placebo. This finding does not rule out the possibility that some children experience increased anxiety when treated with psychostimulants, but suggests that those risks are outweighed by the number of children who experience improvement in anxiety symptoms (possibly as a secondary effect of improved control of ADHD symptoms). Clinicians should consider rechallenging children with ADHD who report new-onset or worsening anxiety with psychostimulants, as these symptoms are much more likely to be coincidental rather than caused by psychostimulants.
conferenceObject Serotonin reuptake inhibitor augmentation with n-acetylcysteine in treatment resistant ocd: a double-blind randomized controlled trial(2015) COSTA, D. L. C.; DINIZ, J. B.; JOAQUIM, M.; ACCIARITO, A. C.; RODRIGUES, B.; ODA, E.; REQUENA, G.; MIGUEL, E. C.; SHAVITT, R. GedankeconferenceObject Serotonin Reuptake Inhibitor Augmentation with N-Acetylcysteine in Treatment Resistant Obsessive-Compulsive Disorder: A Double-blind Randomized Controlled Trial(2015) COSTA, Daniel L. C.; DINIZ, Juliana B.; JOAQUIM, Marines; ACCIARITO, Ana C.; RODRIGUES, Bernardo; ODA, Eduardo F.; REQUENA, Guaraci; MIGUEL, Euripedes C.; PITTENGER, Christopher; BLOCH, Michael H.; SHAVITT, Roseli G.- Risk of Irritability With Psychostimulant Treatment in Children With ADHD: A Meta-Analysis(2017) STUCKELMAN, Zachary D.; MULQUEEN, Jilian M.; FERRACIOLI-ODA, Eduardo; COHEN, Stephanie C.; COUGHLIN, Catherine G.; LECKMAN, James F.; BLOCH, Michael H.Objective: Irritability is listed as a common side effect of psychostimulant medications. However, psychostimulants have been demonstrated as an effective treatment in reducing irritability and aggression in children with attention-deficit/hyperactivity disorder (ADHD). The goal of this study was to quantify the risk of irritability as a side effect of psychostimulant treatment for ADHD. Data Sources and Study Selection: A PubMed search was conducted on August 18, 2013, to identify all double-blind, randomized, placebo-controlled trials published in English examining the efficacy of psychostimulant medications in the treatment of children with ADHD. Trials were excluded if (1) they required additional psychiatric or medical comorbidity in addition to ADHD, (2) they involved fewer than 20 subjects (parallel group trials), or (3) children received psychostimulant medication for less than 1 week. Data Extraction: A fixed-effects meta-analysis was used to examine the risk ratio of irritability reported as a side effect in children treated with psychostimulants compared to placebo. Stratified subgroup analysis and meta-regression were used to examine the effects of stimulant type, dosage, duration of use, and trial design on the measured risk of irritability. Results: From 92 potentially eligible trials, the meta-analysis identified 32 trials involving 3,664 children with ADHD that reported data on irritability as a side effect. The relative risk of irritability significantly differed between psychostimulant classes (test for subgroup differences.2 1 = 7.6, P =.006). Methylphenidate derivatives were associated with a significantly decreased risk of irritability compared to placebo (risk ratio [RR] = 0.89 [95% CI, 0.82 to 0.96], z = -2.87, P =.004, k = 32, I2 = 50%), whereas amphetamine derivatives were associated with a significantly increased risk of irritability (RR = 2.90 [95% CI, 1.26 to 6.71], z = 2.5, P =.01, k = 5, I2 = 0%). Conclusions: This meta-analysis suggests an increased risk of irritability may be confined to amphetamine-derived psychostimulants. Future meta-analyses examining the effects of amphetamine and methylphenidate derivatives on irritability as a continuous measure, as well as head-to-head trials between methylphenidate and amphetamine derivatives examining effects on irritability, will be important to replicate the findings of this meta-analysis. (C) Copyright 2017 Physicians Postgraduate Press, Inc.