PMID- 36649794
OWN - NLM
STAT- MEDLINE
DCOM- 20230620
LR  - 20230624
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 257
DP  - 2023 Jun
TI  - Adverse Effects of alpha-2 Adrenergic Agonists and Stimulants in Preschool-age 
      Attention-deficit/Hyperactivity Disorder: A Developmental-Behavioral Pediatrics 
      Research Network Study.
PG  - 113325
LID - S0022-3476(23)00021-5 [pii]
LID - 10.1016/j.jpeds.2023.01.004 [doi]
AB  - OBJECTIVES: To characterize and compare the type and frequency of a range of 
      common and uncommon adverse effects (AEs) associated with alpha-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      withdrawn behavior, and weight loss.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.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Loe, Irene M
AU  - Loe IM
AD  - Department of Pediatrics, Stanford University, Stanford, CA. Electronic address: 
      iloe@stanford.edu.
FAU - Blum, Nathan J
AU  - Blum NJ
AD  - Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; 
      Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
FAU - Shults, Justine
AU  - Shults J
AD  - Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA; 
      Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
FAU - Barbaresi, William
AU  - Barbaresi W
AD  - Division of Developmental Medicine, Department of Pediatrics, Boston Children's 
      Hospital, Boston, MA.
FAU - Bax, Ami
AU  - Bax A
AD  - Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma 
      City, OK.
FAU - Cacia, Jaclyn
AU  - Cacia J
AD  - Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.
FAU - Deavenport-Saman, Alexis
AU  - Deavenport-Saman A
AD  - 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.
FAU - Friedman, Sandra
AU  - Friedman S
AD  - Department of Pediatrics, University of Colorado School of Medicine, Children's 
      Hospital Colorado, Aurora, CO.
FAU - LaRosa, Angela
AU  - LaRosa A
AD  - Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
FAU - Mittal, Shruti
AU  - Mittal S
AD  - Department of Pediatrics, Atrium Health, Concord, NC.
FAU - Vanderbilt, Douglas
AU  - Vanderbilt D
AD  - 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.
FAU - Harstad, Elizabeth
AU  - Harstad E
AD  - Division of Developmental Medicine, Department of Pediatrics, Boston Children's 
      Hospital, Boston, MA.
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20230114
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Central Nervous System Stimulants)
RN  - 0 (Adrenergic Agonists)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Humans
MH  - *Attention Deficit Disorder with Hyperactivity/drug therapy
MH  - Retrospective Studies
MH  - Prospective Studies
MH  - *Central Nervous System Stimulants/adverse effects
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Adrenergic Agonists/therapeutic use
MH  - *Pediatrics
OTO - NOTNLM
OT  - adverse events
OT  - early childhood
OT  - medication
OT  - nonstimulant
OT  - psychopharmacology
OT  - side effects
EDAT- 2023/01/18 06:00
MHDA- 2023/06/20 06:42
CRDT- 2023/01/17 19:19
PHST- 2022/07/29 00:00 [received]
PHST- 2022/12/16 00:00 [revised]
PHST- 2023/01/11 00:00 [accepted]
PHST- 2023/06/20 06:42 [medline]
PHST- 2023/01/18 06:00 [pubmed]
PHST- 2023/01/17 19:19 [entrez]
AID - S0022-3476(23)00021-5 [pii]
AID - 10.1016/j.jpeds.2023.01.004 [doi]
PST - ppublish
SO  - J Pediatr. 2023 Jun;257:113325. doi: 10.1016/j.jpeds.2023.01.004. Epub 2023 Jan 
      14.