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Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis

There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on...

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Autores principales: Pan, Pei-Yin, Jonsson, Ulf, Şahpazoğlu Çakmak, Sabriye Selin, Häge, Alexander, Hohmann, Sarah, Nobel Norrman, Hjalmar, Buitelaar, Jan K., Banaschewski, Tobias, Cortese, Samuele, Coghill, David, Bölte, Sven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711104/
https://www.ncbi.nlm.nih.gov/pubmed/34635194
http://dx.doi.org/10.1017/S0033291721004141
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author Pan, Pei-Yin
Jonsson, Ulf
Şahpazoğlu Çakmak, Sabriye Selin
Häge, Alexander
Hohmann, Sarah
Nobel Norrman, Hjalmar
Buitelaar, Jan K.
Banaschewski, Tobias
Cortese, Samuele
Coghill, David
Bölte, Sven
author_facet Pan, Pei-Yin
Jonsson, Ulf
Şahpazoğlu Çakmak, Sabriye Selin
Häge, Alexander
Hohmann, Sarah
Nobel Norrman, Hjalmar
Buitelaar, Jan K.
Banaschewski, Tobias
Cortese, Samuele
Coghill, David
Bölte, Sven
author_sort Pan, Pei-Yin
collection PubMed
description There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63–2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06–1.56), guanfacine (OR = 1.43, 95% CI = 1.12–1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09–1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.
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spelling pubmed-87111042022-01-07 Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis Pan, Pei-Yin Jonsson, Ulf Şahpazoğlu Çakmak, Sabriye Selin Häge, Alexander Hohmann, Sarah Nobel Norrman, Hjalmar Buitelaar, Jan K. Banaschewski, Tobias Cortese, Samuele Coghill, David Bölte, Sven Psychol Med Review Article There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63–2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06–1.56), guanfacine (OR = 1.43, 95% CI = 1.12–1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09–1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended. Cambridge University Press 2022-01 2021-10-12 /pmc/articles/PMC8711104/ /pubmed/34635194 http://dx.doi.org/10.1017/S0033291721004141 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Review Article
Pan, Pei-Yin
Jonsson, Ulf
Şahpazoğlu Çakmak, Sabriye Selin
Häge, Alexander
Hohmann, Sarah
Nobel Norrman, Hjalmar
Buitelaar, Jan K.
Banaschewski, Tobias
Cortese, Samuele
Coghill, David
Bölte, Sven
Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title_full Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title_fullStr Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title_full_unstemmed Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title_short Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis
title_sort headache in adhd as comorbidity and a side effect of medications: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711104/
https://www.ncbi.nlm.nih.gov/pubmed/34635194
http://dx.doi.org/10.1017/S0033291721004141
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