SynthesisJournal of the American Academy of Child and Adolescent Psychiatry2009
Meta-analysis: treatment of attention-deficit/hyperactivity disorder in children with comorbid tic disorders.
Synthesis in Journal of the American Academy of Child and Adolescent Psychiatry, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 8 syntheses or guidelines pooled it, 268 citations in OpenAlex.
- Pharmacological Interventions for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents with Tourette Disorder: A Systematic Review and Network Meta-Analysis.Journal of child and adolescent psychopharmacology · 2024Pooled it
- Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).The Cochrane database of systematic reviews · 2023Pooled it
- Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders.The Cochrane database of systematic reviews · 2018Pooled it
- Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials.BMJ (Clinical research ed.) · 2015Pooled it
- Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).The Cochrane database of systematic reviews · 2015Pooled it
- Systematic review: pharmacological treatment of tic disorders--efficacy of antipsychotic and alpha-2 adrenergic agonist agents.Neuroscience and biobehavioral reviews · 2013Pooled it
- European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment.European child & adolescent psychiatry · 2011Guideline
- European guidelines on managing adverse effects of medication for ADHD.European child & adolescent psychiatry · 2011Guideline
- Extended Release Guanfacine in Pediatric Anxiety Disorders: A Pilot, Randomized, Placebo-Controlled Trial.Journal of child and adolescent psychopharmacology · 2017Trial
- N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial.Journal of child and adolescent psychopharmacology · 2016Trial
- Ningdong granule: a complementary and alternative therapy in the treatment of attention deficit/hyperactivity disorder.Psychopharmacology · 2011Trial
- Psychiatric Comorbidity, Tic Severity and Quality of Life in Adults with Tourette's Syndrome.Movement disorders clinical practice · 2026Article
- From Pharmacological Treatment to Neuromodulation: A Comprehensive Approach to Managing Gilles de la Tourette Syndrome.International journal of molecular sciences · 2025Review
- Article
- A Tourette Syndrome/ADHD-like Phenotype Results from Postnatal Disruption of CBInternational journal of molecular sciences · 2025Article
- Attention-deficit/hyperactivity disorder.Nature reviews. Disease primers · 2024Review
- Comparative Effectiveness of Pharmacotherapies for the Risk of Attempted or Completed Suicide Among Persons With Borderline Personality Disorder.JAMA network open · 2023Article
- Lifetime Prevalence, Predictors and Comorbidities of Tic Disorders: A Population-Based Survey of Children and Adolescents in Iran.Child psychiatry and human development · 2022Article
- Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder.Soa--ch'ongsonyon chongsin uihak = Journal of child & adolescent psychiatry · 2022Review
- Association of mental disorders and strabismus among South Korean children and adolescents: a nationwide population-based study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe Food and Drug Administration currently requires the package inserts of most psychostimulant medications to list the presence of a tic disorder as a contraindication to their use. Approximately half of children with Tourette's syndrome experience comorbid attention-deficit/hyperactivity disorder (ADHD). We sought to determine the relative efficacy of different medications in treating ADHD and tic symptoms in children with both Tourette's syndrome and ADHD.
methodWe conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of medications in the treatment of ADHD in the children with comorbid tics. We used a random effects meta-analysis with standardized mean difference as our primary outcome to estimate the effect size of pharmaceutical agents in the treatment of ADHD symptoms and tics.
resultsOur meta-analysis included nine studies involving 477 subjects. We assessed the efficacy of six medications-dextroamphetamine, methylphenidate, alpha-2 agonists (clonidine and guanfacine), desipramine, atomoxetine, and deprenyl. Methylphenidate, alpha-2 agonists, desipramine, and atomoxetine demonstrated efficacy in improving ADHD symptoms in children with comorbid tics. Alpha-2 agonists and atomoxetine significantly improved comorbid tic symptoms. Although there was evidence that supratherapeutic doses of dextroamphetamine worsens tics, there was no evidence that methylphenidate worsened tic severity in the short term.
conclusionsMethylphenidate seems to offer the greatest and most immediate improvement of ADHD symptoms and does not seem to worsen tic symptoms. Alpha-2 agonists offer the best combined improvement in both tic and ADHD symptoms. Atomoxetine and desipramine offer additional evidence-based treatments of ADHD in children with comorbid tics. Supratherapeutic doses of dextroamphetamine should be avoided.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.