The Role of Alpha-2 Agonists for Attention Deficit Hyperactivity Disorder in Children: A Review

Author:

Neuchat Elisa E.1,Bocklud Brooke E.1,Kingsley Kali1,Barham William T.2,Luther Patrick M.1,Ahmadzadeh Shahab3,Shekoohi Sahar3ORCID,Cornett Elyse M.3ORCID,Kaye Alan D.34ORCID

Affiliation:

1. School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA

2. School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA 70112, USA

3. Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA

4. Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA

Abstract

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders, characterized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is marked by symptoms such as inappropriate levels of inattention, hyperactivity, and impulsivity that can affect academic, social, and personal functioning in children and adolescents. This review summarizes clinical trials demonstrating the effectiveness of Alpha-2 agonists in reducing symptoms of inattention, hyperactivity, and impulsivity in children with ADHD. Studies were identified through a systematic search of PubMed and Cochrane databases. However, these medications’ long-term safety and efficacy remain uncertain, with a lack of data on their effects on growth, cardiovascular function, and other adverse events. Further studies are required to determine these medications’ optimal dose and treatment duration. Methods: Medications that target the noradrenergic system, such as Alpha-2 agonists, have been increasingly used as a treatment option for ADHD, with guanfacine and clonidine being two of the most commonly used medications. They function by selectively targeting Alpha-2 adrenergic receptors in the brain leading to improved attention and reduced hyperactivity and impulsivity symptoms in children with ADHD. Results: Clinical trials have demonstrated the effectiveness of Alpha-2 agonists in treating ADHD in children by reducing symptoms of inattention, hyperactivity, and impulsivity. However, these medications’ long-term safety and efficacy still need to be completely understood. Due to a lack of information on the effects of Alpha-2 agonists on growth, cardiovascular function, and other long-term adverse events, more studies must investigate the optimal dose and treatment duration for these medications. Conclusions: Despite these concerns, Alpha-2 agonists remain a valuable treatment option for ADHD in children, especially those unable to tolerate stimulant medications or who have coexisting conditions such as tic disorders. Future research should continue to explore the safety and efficacy of Alpha-2 agonists in the long term. In conclusion, Alpha-2 agonists show promise as a treatment for ADHD in children; however, the safety and efficacy of these drugs in the long term are not yet completely understood. Additional studies are required to investigate the optimal dose and treatment duration for these medications in their use as a treatment for this debilitating disease.

Publisher

MDPI AG

Subject

Neurology (clinical)

Reference59 articles.

1. NIMH (2023, April 03). Attention-Deficit/Hyperactivity Disorder in Children and Teens: What You Need to Know, Available online: https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-in-children-and-teens-what-you-need-to-know.

2. Treatment of adults with attention-deficit/hyperactivity disorder;Hechtman;Neuropsychiatr. Dis. Treat.,2008

3. Alpha-2 Adrenergic Receptors and Attention-Deficit/Hyperactivity Disorder;Bidwell;Curr. Psychiatry Rep.,2010

4. Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders;Osland;Cochrane Database Syst. Rev.,2018

5. A Randomized, Double-Blind, Placebo-Controlled Phase 2 Study of α4β2 Agonist ABT-894 in Adults with ADHD;Bain;Neuropsychopharmacology,2013

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