Large Study Analyzes Two Different Classes of ADHD Drugs in Preschool-Age Children

By Children's Hospital Of Philadelphia8 days ago

PHILADELPHIA, May 4, 2021 /PRNewswire/ --In a multi-institutional study, researchers in the Developmental-Behavioral Pediatrics Research Network (DBPNet), led by Children's Hospital of Philadelphia (CHOP), have conducted the first and largest analysis to date comparing the effectiveness and side effects of stimulants like methylphenidate (Ritalin) and alpha-adrenergic agonists like guanfacine (Tenex) in preschool-age children. The researchers found that both classes of drugs have benefits, with differing side effects, suggesting that decisions on which class of drugs to prescribe should be made based on individual patient factors. The retrospective study was published today in JAMA.

Nathan J. Blum, MD

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This is really the first study of any size to report on the frequency of improvement and side effects of drugs like guanfacine in preschool-age children, said senior author Nathan J. Blum, MD, Chief of the Division of Developmental and Behavioral Pediatrics at CHOP. While this study confirms that clinicians are using drugs like guanfacine in preschoolers and that those drugs may be useful in some children, the research also strongly suggests we need future research to look in a rigorous way at the use of alpha-adrenergic agonists in this age group.

To assess the use, effectiveness, and side effects of stimulants and alpha-adrenergic agonists in preschoolers, the researchers reviewed electronic health records of 497 children seen at seven DBPNet outpatient developmental-behavioral pediatric practices between January 2013 and July 2017. Children included in the study were under the age of 6 when first treated with an alpha-adrenergic agonist or stimulant.

The researchers found that 175 children (35%) were prescribed an alpha-adrenergic agonist like guanfacine, while 322 children (65%) were prescribed a stimulant like methylphenidate (Ritalin). Although both groups reported improvement in symptoms, the benefit was slightly larger among those prescribed stimulants (78% vs. 66%).

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