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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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Main Authors: Pan, Pei-Yin (Author) , Jonsson, Ulf (Author) , Çakmak, Sabriye Selin Şahpazoğlu (Author) , Häge, Alexander (Author) , Hohmann, Sarah (Author) , Norrman, Hjalmar Nobel (Author) , Buitelaar, Jan K. (Author) , Banaschewski, Tobias (Author) , Cortese, Samuele (Author) , Coghill, David (Author) , Bölte, Sven (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: Psychological medicine
Year: 2022, Volume: 52, Issue: 1, Pages: 14-25
ISSN:1469-8978
DOI:10.1017/S0033291721004141
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1017/S0033291721004141
Verlag, kostenfrei, Volltext: https://www.cambridge.org/core/journals/psychological-medicine/article/headache-in-adhd-as-comorbidity-and-a-side-effect-of-medications-a-systematic-review-and-metaanalysis/86B4FF59071AE58B9730EE3D665914A8
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Author Notes:Pei-Yin Pan, Ulf Jonsson, Sabriye Selin Şahpazoğlu Çakmak, Alexander Häge, Sarah Hohmann, Hjalmar Nobel Norrman, Jan K. Buitelaar, Tobias Banaschewski, Samuele Cortese, David Coghill and Sven Bölte
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Summary: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.
Item Description:First published online: 12 October 2021
Gesehen am 25.05.2023
Physical Description:Online Resource
ISSN:1469-8978
DOI:10.1017/S0033291721004141

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