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 .
The treatment of attention-deficit hyperactivity disorder in Tourette's syndrome: a double-blind placebo-controlled study with clonidine and desipramine.
OBJECTIVES Because psychostimulants can exacerbate preexisting motor/phonic tics in individuals with Tourette 's syndrome ( TS ) , a clinical trial was performed to examine the ability of clonidine and desipramine to modify attention-deficit hyperactivity disorder ( ADHD ) behaviors in children with TS + ADHD . METHODS A double-blind , placebo-controlled protocol was used in which each subject served as his or her own control and received , in a r and omly assigned fashion , 6-week medication cycles with clonidine ( 0.05 mg four times daily ) , desipramine ( 25 mg four times daily ) , and placebo . RESULTS Thirty-seven children with TS+ADHD between the ages 7 to 13 years and of normal intellect were recruited , and 34 ( 31 males , 3 females ) completed the entire protocol . Outcome measures for ADHD included Parent and Teacher Child Behavior Checklists ( CBCL ) , continuous performance tests , and neuropsychologic tests of executive function . Several markers for ADHD were shown to improve significantly ( P < .05 ) after treatment with desipramine  ( parent linear analogue rating , parent CBCL " hyperactivity " subscale , and teacher CBCL subscales " nervous/overactive , " " anxious , " and " unpopular " ) . Improvement with desipramine was always superior to that noted with clonidine .  Clinical improvement did not correlate with drug blood levels . On measures of tic severity , neither drug made tics worse .  Desipramine showed a statistically significant improvement on a global linear analogue scale , but not on the Hopkins Motor/Vocal Tic Severity Scale , the Tourette Syndrome Severity Scale , or the Yale Global Tic Severity Scale .  Clonidine did not significantly alter tic severity on any measure . CONCLUSION The results of this study suggest that desipramine may be a useful alternative for the treatment of symptoms of ADHD in children with TS
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 .