Risk of Irritability With Psychostimulant Treatment in Children With ADHD: A Meta-Analysis
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Citações na Scopus
27
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
PHYSICIANS POSTGRADUATE PRESS
Autores
STUCKELMAN, Zachary D.
MULQUEEN, Jilian M.
COHEN, Stephanie C.
COUGHLIN, Catherine G.
LECKMAN, James F.
BLOCH, Michael H.
Citação
JOURNAL OF CLINICAL PSYCHIATRY, v.78, n.6, p.E648-E655, 2017
Resumo
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.
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Referências
- AHMANN PA, 1993, PEDIATRICS, V91, P1101
- American Psychiatric Association,, 2013, DIAGNOSTIC STAT MANU
- Arnold L. E., 2000, J ATTEN DISORD, V3, P200, DOI 10.1177/108705470000300403
- BARKLEY RA, 1990, PEDIATRICS, V86, P184
- Biederman J, 2007, CLIN THER, V29, P450, DOI 10.1016/j.clinthera.2007.03.006
- Brotman MA, 2006, BIOL PSYCHIAT, V60, P991, DOI 10.1016/j.biopsych.2006.08.042
- Buitelaar JK, 1996, J CHILD PSYCHOL PSYC, V37, P587, DOI 10.1111/j.1469-7610.1996.tb01445.x
- Childress AC, 2009, J CHILD ADOL PSYCHOP, V19, P351, DOI 10.1089/cap.2009.0007
- Coccaro EF, 2015, CNS SPECTRUMS, V20, P295, DOI 10.1017/S1092852915000310
- CONNERS CK, 1980, ARCH GEN PSYCHIAT, V37, P922
- Connor DF, 2002, J AM ACAD CHILD PSY, V41, P253, DOI 10.1097/00004583-200203000-00004
- CROWLEY TJ, 1972, PSYCHOPHARMACOLOGIA, V27, P213, DOI 10.1007/BF00422801
- de Almeida RMM, 2005, EUR J PHARMACOL, V526, P51, DOI 10.1016/j.ejphar.2005.10.004
- de la Cruz L Fernandez, 2015, J AM ACAD CHILD ADOL, V54
- Dougherty DD, 2006, DEPRESS ANXIETY, V23, P175, DOI 10.1002/da.20168
- DURING MJ, 1992, NEUROSCI LETT, V140, P129, DOI 10.1016/0304-3940(92)90698-7
- Efron D, 1997, PEDIATRICS, V100, P662, DOI 10.1542/peds.100.4.662
- Ferrari PF, 2003, EUR J NEUROSCI, V17, P371, DOI 10.1046/j.1460-9568.2003.02447.x
- Findling RL, 2006, EUR CHILD ADOLES PSY, V15, P450, DOI 10.1007/s00787-006-0565-0
- Findling RL, 2011, J AM ACAD CHILD PSY, V50, P395, DOI 10.1016/j.jaac.2011.01.007
- Firestone P, 1998, J CHILD ADOL PSYCHOP, V8, P13, DOI 10.1089/cap.1998.8.13
- FITZPATRICK PA, 1992, J AM ACAD CHILD PSY, V31, P226, DOI 10.1097/00004583-199203000-00008
- Fleckenstein AE, 1999, EUR J PHARMACOL, V382, P45, DOI 10.1016/S0014-2999(99)00588-9
- Gadow KD, 2014, J AM ACAD CHILD ADOL, V53
- Gadow KD, 2014, J AM ACAD CHILD ADOL, V53, pe1
- GITTELMANKLEIN R, 1976, ARCH GEN PSYCHIAT, V33, P1217
- Gorman EB, 2006, J AM ACAD CHILD PSY, V45, P808, DOI 10.1097/01.chi.0000214191.57993.dd
- GREENBERG LM, 1972, AM J PSYCHIAT, V129, P532
- Greenhill LL, 2006, J AM ACAD CHILD PSY, V45, P817, DOI 10.1097/01.chi.0000220847.41027.5d
- Greenhill LL, 2002, PEDIATRICS, V109, DOI 10.1542/peds.109.3.e39
- Harpin VA, 2005, ARCH DIS CHILD, V90, pI2, DOI 10.1136/adc.2004.059006
- Hess EJ, 1996, J NEUROSCI, V16, P3104
- KANTAK KM, 1988, PSYCHOPHARMACOLOGY, V96, P468, DOI 10.1007/BF02180026
- KLORMAN R, 1990, J AM ACAD CHILD PSY, V29, P702, DOI 10.1097/00004583-199009000-00005
- Kuczenski R, 1997, J NEUROCHEM, V68, P2032
- Lee J, 2011, BMC PSYCHIATRY, V11, DOI 10.1186/1471-244X-11-70
- MICZEK KA, 1974, PSYCHOPHARMACOLOGIA, V39, P275, DOI 10.1007/BF00422968
- Newcorn JH, 2008, AM J PSYCHIAT, V165, P721, DOI 10.1176/appi.ajp.2007.05091676
- Pappadopulos E, 2006, J CAN ACAD CHILD ADO, V15, P27
- Pliszka SR, 2000, J AM ACAD CHILD PSY, V39, P619, DOI 10.1097/00004583-200005000-00016
- RAPOPORT JL, 1974, ARCH GEN PSYCHIAT, V30, P789
- RAPPORT MD, 1985, J ABNORM CHILD PSYCH, V13, P227, DOI 10.1007/BF00910644
- Safer Daniel J, 2009, Child Adolesc Psychiatry Ment Health, V3, P35, DOI 10.1186/1753-2000-3-35
- Schachar R, 2008, J CHILD ADOL PSYCHOP, V18, P11, DOI 10.1089/cap.2007.0039
- Schulz E, 2010, J CHILD ADOL PSYCHOP, V20, P377, DOI 10.1089/cap.2009.0106
- Shaw P, 2014, AM J PSYCHIAT, V171, P276, DOI 10.1176/appi.ajp.2013.13070966
- Solanto M, 2009, J CHILD ADOL PSYCHOP, V19, P663, DOI 10.1089/cap.2009.0033
- Stein MA, 2003, PEDIATRICS, V112, pE404, DOI 10.1542/peds.112.5.e404
- Stein MA, 1996, PEDIATRICS, V98, P748
- Stringaris A, 2009, J CHILD PSYCHOL PSYC, V50, P216, DOI 10.1111/j.1469-7610.2008.01989.x
- Swanson JM, 2004, PEDIATRICS, V113, pE206, DOI 10.1542/peds.113.3.e206
- Swenson M, STIMULANT EQUIVALENC
- WERRY JS, 1980, J CHILD PSYCHOL PSYC, V21, P27, DOI 10.1111/j.1469-7610.1980.tb00013.x
- WERRY JS, 1974, AUST NZ J PSYCHIAT, V8, P9, DOI 10.3109/00048677409159770
- Wigal Sharon B, 2009, Child Adolesc Psychiatry Ment Health, V3, P17, DOI 10.1186/1753-2000-3-17
- Wigal T, 2006, J AM ACAD CHILD PSY, V45, P1294, DOI 10.1097/01.chi.0000235082.63156.27
- Wilens TE, 2010, J CLIN PSYCHIAT, V71, P548, DOI 10.4088/JCP.09m05779pur