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Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents

Safety Considerations

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Abstract

Despite a large body of evidence for both the validity of the diagnosis of attention deficit hyperactivity disorder (ADHD) and the efficacy of its treatment with medication, there is an equally long history of controversy. This article focuses on presenting safety information for medications approved by the US FDA for the treatment of individuals with ADHD.

Stimulant medications are generally safe and effective. The common adverse effects of stimulant medications, including appetite suppression and insomnia, are usually of mild severity and manageable without stopping the medication. The more severe adverse effects such as tics or bizarre behaviours occur with low frequency and usually resolve when the medication is stopped. The possible impact on growth requires careful monitoring. Several rare but potentially severe adverse effects including sudden cardiac death and cancer following long-term treatment have been reported; however, these effects have not been adequately demonstrated to be of significant concern at this time. Atomoxetine also has a mild adverse effect profile in terms of severity and frequency although the numbers of studies and years of clinical experience is considerably less with this drug than for the stimulant medications.

When the risks are juxtaposed to the clear efficacy in significantly reducing dysfunctional symptoms of ADHD, benefit-risk analyses support the continued use of these pharmacological treatments for patients with ADHD.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

No sources of funding were used in the preparation of this review. Laura McGuinn and Melissa Doffing have no conflicts of interest relevant to the content of this review. Mark Wolraich is a consultant to Shire and Eli Lilly and has received research support from Eli Lilly. He has also acted as a consultant to McNeil.

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Authors and Affiliations

  1. Department of Pediatrics, Section of Developmental and Behavioral Pediatrics, University of Oklahoma Health Sciences Center, OU Child Study Center, 1100 N.E. 13th Street, Oklahoma City, Oklahoma, 73117, USA

    Mark L. Wolraich, Laura McGuinn & Melissa Doffing

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  3. Melissa Doffing
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Wolraich, M.L., McGuinn, L. & Doffing, M. Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents. Drug-Safety 30, 17–26 (2007). https://doi.org/10.2165/00002018-200730010-00003

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