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 .
Outcomes of OROS® methylphenidate compared with atomoxetine in children with ADHD: A multicenter, randomized prospective study
This community-based study was design ed to evaluate treatment outcomes with OROS ® methylpheni date ( MPH ) and atomoxetine in children with attentiondeficit/hyperactivity disorder ( ADHD ) , as assessed by physicians and parents in a setting that resembles clinical practice . In a multicenter , prospect i ve , open-label study , children 6 to 12 years of age with ADHD were r and omized ( 2:1 , respectively ) to 3 weeks of treatment with once-daily OROS MPH or atomoxetine . Investigatorrated measures of symptoms included the ADHD Rating Scale ( ADHD-RS ) and the Clinical Global Impression-Improvement of Illness scale ( CGI-I ) . Assessment s were made at baseline and during a telephone interview in week 1 , a clinic visit in week 2 , and a final clinic visit in week 3 . In total , 1323 patients received OROS MPH ( n=850 ) or atomoxetine ( n=473 ) . Significant reductions from baseline in investigator-evaluated ADHD-RS scores were observed among patients receiving OROS MPH and those receiving atomoxetine . At the end of the study , mean decreases from baseline ADHD-RS scores were 20.24 for OROS MPH and 16 for atomoxetine ( P < .001 ) . Between-treatment differences appeared to increase over time ( 2.77 , 3.44 , and 4.24 at weeks 1 , 2 , and 3 , respectively ; P < .001 ) . Treatment response ( ie , 25 % reduction from baseline ADHD-RS scores ) was significantly greater at each evaluation for patients taking OROS MPH than for those taking atomoxetine ( P < .001 ) . Similar percentages of patients taking OROS MPH ( 4.8 % ) and atomoxetine ( 5.5 % ) withdrew because of adverse events . Although community-based studies often lack the control of r and omized , placebo-controlled trials , these results nevertheless suggest greater ADHD symptom improvement  with OROS MPH compared with atomoxetine
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 .