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 Extended-Release Tablets as Add-on Therapy to Psychostimulants in Children and Adolescents With ADHD
OBJECTIVE : To assess the efficacy and safety of clonidine hydrochloride extended-release tablets ( CLON-XR ) combined with stimulants ( ie , methylpheni date or amphetamine ) for attention-deficit/hyperactivity disorder ( ADHD ) . PATIENTS AND METHODS : In this phase 3 , double-blind , placebo-controlled trial , children and adolescents with hyperactive- or combined-subtype ADHD who had an inadequate response to their stable stimulant regimen were r and omized to receive CLON-XR or placebo in combination with their baseline stimulant medication . Predefined efficacy measures evaluated change from baseline to week 5 . Safety was assessed by spontaneously reported adverse events , vital signs , electrocardiogram recordings , and clinical laboratory values . Improvement from baseline for all efficacy measures was evaluated using analysis of covariance . RESULTS : Of 198 patients r and omized , 102 received CLON-XR plus stimulant and 96 received placebo plus stimulant . At week 5 , greater improvement from baseline in ADHD Rating Scale IV ( ADHD-RS-IV ) total score ( 95 % confidence interval : −7.83 to −1.13 ; P = .009 ) , ADHD-RS-IV hyperactivity and inattention subscale scores ( P = .014 and P = .017 , respectively ) , Conners ' Parent Rating Scale scores ( P < .062 ) , Clinical Global Impression of Severity ( P = .021 ) , Clinical Global Impression of Improvement ( P = .006 ) , and Parent Global Assessment ( P = .001 ) was observed in the CLON-XR plus stimulant group versus the placebo plus stimulant group . Adverse events and changes in vital signs in the CLON-XR group were generally mild . CONCLUSIONS : The results of this study suggest that CLON-XR in combination with stimulants is useful in reducing ADHD in children and adolescents with partial response to stimulants
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 .