Agonistas o estimulantes α2-adrenérgicos para niños en edad preescolar con trastorno por déficit de
Elizabeth Harstad1, Justine Shults2,3, William Barbaresi1
1Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts.
JAMA
|May 4, 2021
Resumen
Los estimulantes mostraron tasas de mejoría más altas para el TDAH preescolar, pero los agonistas α2-adrenérgicos tuvieron menos efectos adversos. Se necesita más investigación para comparar estos medicamentos para el TDAH en niños pequeños.
Área de la Ciencia:
- Neurología pediátrica
- Pediatría del comportamiento del desarrollo
- Farmacología
Sus antecedentes:
- El trastorno por déficit de atención e hiperactividad (TDAH) afecta aproximadamente al 2,4% de los niños en edad preescolar.
- Los estimulantes son tratamientos de primera línea, sin embargo, los agonistas α2-adrenérgicos se utilizan en hasta el 25% de los casos a pesar de los datos limitados de eficacia y seguridad en este grupo de edad.
Objetivo del estudio:
- Determinar la frecuencia de la mejora de los síntomas y los efectos adversos de los agonistas α2-adrenérgicos frente a los medicamentos estimulantes en niños en edad preescolar con TDAH.
Principales métodos:
- Revisión retrospectiva de los registros electrónicos de salud de 497 niños menores de 72 meses iniciados con medicamentos para el TDAH.
- Datos extraídos de 7 prácticas pediátricas de desarrollo y comportamiento de los Estados Unidos entre 2013 y 2017.
Principales resultados:
- Se informó una mejora en el 66% de los niños tratados con agonistas α2-adrenérgicos y en el 78% con estimulantes.
- La somnolencia diurna fue más común con los agonistas α2-adrenérgicos (38% frente a 3%).
- Los estimulantes se asociaron con un mayor estado de ánimo (50% frente a 29%), supresión del apetito (38% frente a 7%) y dificultades para dormir (21% frente a 11%).
Conclusiones:
- La mayoría de los niños en edad preescolar con TDAH mostraron mejoría con agonistas α2-adrenérgicos o estimulantes.
- Las clases de medicamentos tienen diferentes perfiles de efectos adversos.
- Se necesita más investigación, incluidos ensayos aleatorios, para comparar la eficacia de estos tratamientos para el TDAH.
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