THURSDAY, May 6, 2021 (HealthDay News) — A majority of preschool-aged children with attention-deficit/hyperactivity disorder (ADHD) have improvement with receipt of α2-adrenergic agonists and stimulants, with differing adverse event profiles, according to a study published online May 4 in the Journal of the American Medical Association to coincide with the annual meeting of the Pediatric Academic Societies, held virtually from April 30 to May 4.

Elizabeth Harstad, M.D., M.P.H., from Boston Children’s Hospital, and colleagues examined the frequency of reported improvement in ADHD symptoms and adverse effects associated with α2-adrenergic agonists and stimulant medication for initial treatment of ADHD in 497 children who were younger than 72 months. For initial medication treatment, α2-adrenergic agonists and stimulants were prescribed to 35 and 65 percent of the children, respectively (median length of use, 136 and 133 days, respectively).

The researchers found that 66 and 78 percent of children who initiated α2-adrenergic agonists and stimulants, respectively, reported improvement. For those receiving α2-adrenergic agonists versus stimulants, only daytime sleepiness was more common (38 versus 3 percent); those receiving stimulants versus α2-adrenergic agonists more commonly reported several adverse events, including moodiness/irritability (50 versus 29 percent), appetite suppression (38 versus 7 percent), and difficulty sleeping (21 versus 11 percent).

“Although much still needs to be learned regarding comparative effectiveness of medication treatment for preschool ADHD, the study by Harstad et al provides the foundation for future study and its limitations provide a roadmap for next steps,” write the authors of an accompanying editorial.

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