SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2015
The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.
Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 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
48 citing papers in PubMed, 5 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- The Effects of Theta/Beta-based Neurofeedback Training on Attention in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-analysis.Child psychiatry and human development · 2023Pooled it
- Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis.Scientific reports · 2023Pooled it
- A Systematic Review and Evaluation of Clinical Practice Guidelines for Children and Youth with Disruptive Behavior: Rigor of Development and Recommendations for Use.Clinical child and family psychology review · 2019Pooled it
- Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.Pediatrics · 2019Guideline
- The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 2: antipsychotics and traditional mood stabilizers.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Pooled it
- The effect of phosphatidylserine on behavioral problems in children with attention deficit hyperactivity disorder.Frontiers in psychiatry · 2026Trial
- Components of Behavioral Parent Training for Children With Attention-Deficit/Hyperactivity Disorder: A Series of Replicated Single-Case Experiments.Behavior modification · 2023Trial
- Treatment of disruptive mood dysregulation disorder with autism spectrum disorder and attention-deficit/hyperactivity disorder.The mental health clinician · 2026Article
- Change in vital parameters at first methylphenidate administration as a predictor of treatment response at six-month follow-up.European child & adolescent psychiatry · 2026Article
- Does Combined Stimulant and Psychosocial Treatment in Childhood Attention-Deficit/Hyperactivity Disorder Protect Against Future Substance Use?JAACAP open · 2025Article
- Remote monitoring of wide-ranging real-world changes in adults following ADHD medication initiation.Translational psychiatry · 2025Article
- Article
- Do polygenic indices capture "direct" effects on child externalizing behavior problems? Within-family analyses in two longitudinal birth cohorts.Clinical psychological science : a journal of the Association for Psychological Science · 2025Article
- Rhynchophylline Alleviates Hyperactivity and Cognitive Flexibility Impairment Associated With Inhibition of Inflammatory Responses in Mice That Partly Lack the Dopamine Transporter Protein.Brain and behavior · 2024Article
- Characterizing psychopharmacological prescribing practices in a large cohort of adolescents with borderline personality disorder.Borderline personality disorder and emotion dysregulation · 2024Article
- Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- From Consensus Statement to Pills to Pixels: New Innovations in Attention-Deficit/Hyperactivity Disorder Care.Journal of child and adolescent psychopharmacology · 2024Review
- ADHD medications use and risk of mortality and unintentional injuries: a population-based cohort study.Translational psychiatry · 2024Article
- Plasma fatty acids and attention deficit hyperactivity disorder: a Mendelian randomization investigation.Frontiers in psychiatry · 2024Article
- State of the Evidence for Use of Psychotropic Medications in School-Age Youth.Children (Basel, Switzerland) · 2023Review
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 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveChildren with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms.
methodWe performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach.
resultsTwo systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD.
conclusionsEvidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.
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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.