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 .
A controlled trial of extended-release guanfacine and psychostimulants for attention-deficit/hyperactivity disorder.
OBJECTIVE To examine efficacy , tolerability , and safety of guanfacine extended release ( GXR ; ≤4 mg/d ) adjunctive to a long-acting psychostimulant for the treatment of attention-deficit/hyperactivity disorder ( ADHD ) in children and adolescents 6 to 17 years of age with suboptimal , but partial , response to psychostimulant alone . METHOD In this multicenter , 9-week , double-blind , placebo-controlled , dose-optimization study , subjects ( N = 461 ) continued their stable dose of psychostimulant given in the morning and were r and omized to receive GXR in the morning ( GXR AM ) , GXR in the evening ( GXR PM ) , or placebo .  Efficacy measures included ADHD Rating Scale IV ( ADHD-RS-IV ) and Clinical Global Impressions of Severity of Illness ( CGI-S ) and Improvement ( CGI-I ) scales . Safety measures included adverse events ( AEs ) , vital signs , electrocardiograms , and laboratory evaluations . RESULTS At endpoint , GXR treatment groups showed significantly greater improvement from baseline ADHD-RS-IV total scores compared with placebo plus psychostimulant ( GXR AM , p = .002 ; GXR PM , p < .001 ) . Significant benefits of GXR treatment versus placebo plus psychostimulant were observed on the CGI-S ( GXR AM , p = .013 ; GXR PM , p < .001 ) and CGI-I ( GXR AM , p = .024 ; GXR PM , p = .003 ) . At endpoint , small mean decreases in pulse , systolic , and diastolic blood pressure were observed in GXR treatment groups versus placebo plus psychostimulant . No new safety signals emerged following administration of GXR with psychostimulants versus psychostimulants alone . Most AEs were mild to moderate in severity . CONCLUSIONS Morning or evening GXR administered adjunctively to a psychostimulant showed significantly greater improvement over placebo plus psychostimulant in ADHD symptoms and generated no new safety signals . Clinical trial registration information-Efficacy and Safety of SPD503 in Combination With Psychostimulants ; http://www . clinical trials.gov ; NCT00734578
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 .