There is very-low- quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD , with and without ODD or CD .
There is moderate- quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD , with and without ODD .
There is high- quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD , with and without ODD or CD .
Conclusions : Evidence indicates that psychostimulants , alpha-2 agonists , and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms ; however , psychostimulants generally provide the most benefit
Objective : Children with attention-deficit hyperactivity disorder ( ADHD ) may have oppositional behaviour , conduct problems , and aggression .
These symptoms vary in severity , and may be related to a comorbid diagnosis of oppositional defiant disorder ( ODD ) or conduct disorder ( CD ) .
Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms .
Clonidine benefits children with attention deficit disorder and hyperactivity: report of a double-blind placebo-crossover therapeutic trial.
Ten children ages 8–13 years with attention deficit disorder and hyperactivity ( ADDH ) completed a double-blind placebo-controlled crossover trial consisting of clonidine for 8 weeks and placebo for 4 weeks . The diagnosis was established through a st and ardized clinical interview with parents and children by two child psychiatrists and behavior ratings by parents and teachers . Parents ' behavior ratings showed that 7 of the 10 children clearly benefited from clonidine .  The total score of behavior ratings on Conners ' Scale for the group diminished from pretreatment levels of 66.85 ± 5.75 ( mean ± S.E. ) to 43.00 ± 6.29 by the end of active clonidine treatment ( p = 0.001 ) . Parents rated as the greatest improvement in factors comprising the Hyperactivity Index , and Conduct Problems . Of the 8 children on whom teachers ' ratings were completed , 7 improved with clonidine . Teachers ' overall ratings for the ADDH group before clondidine were 49.00 ± 5.2 and decreased to 25.79 ± 1.3 by the last 2 weeks of active treatment ( p = 0.001 ) . Teachers ' ratings of the " Hyperactivity Index " decreased even more significantly ( 1.99 ± 0.16 ) to 1.12 ± 0.06 by the end of active clondidine treatment ( p = 0.001 ) . The major side effect was sleepiness , which diminished in all but one child by the third week of treatment . Clonidine appears to be a safe , effective medication for a subgroup of children with symptoms of ADDH . Its effectiveness suggests the importance of the norepinephrine system in the pathophysiology of the cognitive and behavioral disturbances in some children with ADDH . Journal of the American Academy of Child Psychiatry , 24 , 5:617–629 , 1985
There is very-low- quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD , with and without ODD or CD .
There is moderate- quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD , with and without ODD .
There is high- quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD , with and without ODD or CD .
Conclusions : Evidence indicates that psychostimulants , alpha-2 agonists , and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms ; however , psychostimulants generally provide the most benefit
Objective : Children with attention-deficit hyperactivity disorder ( ADHD ) may have oppositional behaviour , conduct problems , and aggression .
These symptoms vary in severity , and may be related to a comorbid diagnosis of oppositional defiant disorder ( ODD ) or conduct disorder ( CD ) .
Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms .