Desipramine appeared more efficacious than clonidine in reducing ADHD symptoms as rated by parents ( SMD -0.90 , 95 % CI -1.40 to -0.40 , 1 trial , 68 participants , very low quality evidence ) in participants with ADHD and comorbid tics or Tourette syndrome .
Although this Cochrane Review did not identify serious adverse effects in patients taking TCAs , it did identify mild increases in diastolic blood pressure and pulse rates .
Also , patients treated with desipramine had significantly higher rates of appetite suppression compared to placebo whilst nortriptyline result ed in weight gain .
Other reported adverse effects included headache , confusion , sedation , tiredness , blurred vision , diaphoresis , dry mouth , abdominal discomfort , constipation , and urinary retention .
AUTHORS ' CONCLUSIONS Most evidence on TCAs relates to desipramine .
Findings suggest that , in the short term , desipramine improves the core symptoms of ADHD , but its effect on the cardiovascular system remains an important clinical concern .
BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) is a chronic neurodevelopmental disorder of childhood onset , which may persist into adulthood .
ADHD has a significant impact on a child 's daily life , affecting relationships and academic performance .
Its core symptoms include developmentally inappropriate levels of inattention , hyperactivity , and impulsive behaviour .
Tricyclic antidepressants ( TCAs ) are sometimes used as second line of treatment in the reduction of ADHD symptoms in children and adolescents with ADHD .
However , their efficacy is not yet known .
OBJECTIVES To assess the efficacy of TCAs in the reduction of ADHD symptoms within the broad categories of hyperactivity , impulsivity , and inattentiveness in young people aged 6 to 18 years with established diagnoses of ADHD .
A controlled study of nortriptyline in children and adolescents with attention deficit hyperactivity disorder.
OBJECTIVES To study the efficacy and tolerability of nortriptyline ( NT ) in the treatment of pediatric attention deficit hyperactivity disorder ( ADHD ) . METHODOLOGY Subjects were outpatient children and adolescents with ADHD ascertained from clinical referrals . Subjects were enrolled in a 6-week open study in which NT was titrated to 2 mg/kg/day as tolerated over 2 weeks . Using either a 30 % reduction in the ADHD rating scale or a score of 1 or 2 on the Clinical Global Impression ( CGI ) scale for ADHD improvement , responders to treatment were then r and omized into a 3-week , controlled discontinuation phase . During this phase , subjects either continued on their current dose of NT or were tapered to placebo under double-blind conditions . Subjects were monitored for symptoms of ADHD , oppositionality , anxiety , and depression . RESULTS Of the 35 subjects enrolled in the study , 32 completed the open phase and 23 completed the discontinuation phase . The mean dose of NT was 80 mg ( 1.8 mg/kg/day ) , result ing in a serum level of 81 ng/ml . At the conclusion of the open 6-week study , NT was related to a significant reduction in ADHD ( p < 0.001 ) and oppositional symptoms ( p < 0.001 ) . At the conclusion of the discontinuation phase , the 12 subjects r and omized to NT had significantly lower scores on the DSM-IV ADHD symptom checklist than those 11 subjects r and omized to placebo ( 31 versus 21 ; t = 2.2 ; p < 0.04 ) . No significant adverse events were observed , and children were noted to have weight gain during the trial . CONCLUSIONS These data suggest that NT is effective in reducing symptoms not only of ADHD but also of oppositionality . This group of children and adolescents tolerated robust dosing of NT well , with few clinical or cardiovascular adverse events
Desipramine appeared more efficacious than clonidine in reducing ADHD symptoms as rated by parents ( SMD -0.90 , 95 % CI -1.40 to -0.40 , 1 trial , 68 participants , very low quality evidence ) in participants with ADHD and comorbid tics or Tourette syndrome .
Although this Cochrane Review did not identify serious adverse effects in patients taking TCAs , it did identify mild increases in diastolic blood pressure and pulse rates .
Also , patients treated with desipramine had significantly higher rates of appetite suppression compared to placebo whilst nortriptyline result ed in weight gain .
Other reported adverse effects included headache , confusion , sedation , tiredness , blurred vision , diaphoresis , dry mouth , abdominal discomfort , constipation , and urinary retention .
AUTHORS ' CONCLUSIONS Most evidence on TCAs relates to desipramine .
Findings suggest that , in the short term , desipramine improves the core symptoms of ADHD , but its effect on the cardiovascular system remains an important clinical concern .
BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) is a chronic neurodevelopmental disorder of childhood onset , which may persist into adulthood .
ADHD has a significant impact on a child 's daily life , affecting relationships and academic performance .
Its core symptoms include developmentally inappropriate levels of inattention , hyperactivity , and impulsive behaviour .
Tricyclic antidepressants ( TCAs ) are sometimes used as second line of treatment in the reduction of ADHD symptoms in children and adolescents with ADHD .
However , their efficacy is not yet known .
OBJECTIVES To assess the efficacy of TCAs in the reduction of ADHD symptoms within the broad categories of hyperactivity , impulsivity , and inattentiveness in young people aged 6 to 18 years with established diagnoses of ADHD .