Back to Search
Start Over
Acute and Long-Term Cardiovascular Effects of Stimulant, Guanfacine, and Combination Therapy for Attention-Deficit/Hyperactivity Disorder
- Source :
- Journal of Child and Adolescent Psychopharmacology. 26:882-888
- Publication Year :
- 2016
- Publisher :
- Mary Ann Liebert Inc, 2016.
-
Abstract
- This study examines cardiovascular (CV) effects of guanfacine immediate-release (GUAN-IR), dexmethylphenidate extended-release (DMPH), and their combination (COMB) during acute and long-term treatment of youth with attention-deficit/hyperactivity disorder.Two hundred seven participants aged 7-14 years enrolled in an 8-week double-blind randomized trial of GUAN-IR (1-3 milligrams (mg)/day), DMPH (5-20 mg/day), or COMB with fixed-flexible dosing and titrated to optimal behavioral response. Heart rate, systolic blood pressure (BP), diastolic BP, and electrocardiograms were assessed at baseline, end of blinded optimization, and over a 1-year open-label maintenance phase.During acute titration, GUAN-IR decreased heart rate, systolic BP, and diastolic BP; DMPH increased heart rate, systolic BP, diastolic BP, and corrected QT (QTc) interval; COMB increased diastolic BP, but had no effects on heart rate, systolic BP, or QTc. During maintenance, GUAN-IR-associated decreases in heart rate and DMPH-associated increases in systolic BP returned to baseline values. Other variables across the three groups remained unchanged from the end of blinded titration. There were no discontinuations due to CV adverse events.GUAN-IR, DMPH, and COMB were well tolerated and safe. Expected changes in CV parameters during acute titration were seen in GUAN-IR and DMPH groups, with COMB values falling intermediately between the two other treatment groups. No serious CV events occurred in any participant. GUAN-IR- and DMPH-associated CV changes generally returned to baseline with sustained therapy. These data suggest that COMB treatment might attenuate long-term CV effects of GUAN-IR and stimulant monotherapy, possibly reducing risk of the small but statistically significant changes associated with either single treatment. Clinicaltrials.gov Identifier: NCT00429273.
- Subjects :
- Male
Time Factors
Adolescent
Dexmethylphenidate Hydrochloride
Dexmethylphenidate
Diastole
Blood Pressure
QT interval
law.invention
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
Heart Rate
law
Heart rate
Adrenergic alpha-2 Receptor Agonists
medicine
Humans
Attention deficit hyperactivity disorder
0501 psychology and cognitive sciences
Pharmacology (medical)
Child
Dose-Response Relationship, Drug
business.industry
05 social sciences
Original Articles
medicine.disease
Guanfacine
Psychiatry and Mental health
Blood pressure
Attention Deficit Disorder with Hyperactivity
Delayed-Action Preparations
Anesthesia
Pediatrics, Perinatology and Child Health
Central Nervous System Stimulants
Drug Therapy, Combination
Female
business
030217 neurology & neurosurgery
050104 developmental & child psychology
medicine.drug
Subjects
Details
- ISSN :
- 15578992 and 10445463
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Journal of Child and Adolescent Psychopharmacology
- Accession number :
- edsair.doi.dedup.....a83d521289fc9103bd552d280318d01e