Section - Quick Takes

03. α2-Adrenergic Agonists or Stimulants for Preschool-Age Children With Attention-Deficit/Hyperactivity Disorder

Published on November 1, 2021 Expired on April 1, 2025

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

In preschool children with ADHD, after behavioral treatment (and sometimes, against guidelines, before behavioral treatment), methylphenidate was associated with better clinical outcomes but more adverse effects than seen in children treated with alpha-adrenergic agonists.

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In a preschool child with an apparent diagnosis of ADHD severe enough to warrant a medication as well as behavioral treatment, which should you begin with—a stimulant or an alpha-adrenergic agonist? Here’s an article that could really help address that question — and from JAMA Psychiatry , no less.

Hi! Jim Phelps here for the Psychopharmacology Institute. First, don’t get your hopes up too high. It’s a retrospective study, not a randomized trial, but this is refreshing. Of the 13 co-authors of this multicenter study from Boston Children’s Hospital and 6 other academic institutions from East to West Coast, none have received money from pharmaceutical companies. So, prepare for a relatively unbiased look at this question, at least with respect to company sponsorship.

First, the authors state in their first paragraph of the Introduction that behavioral treatment is recommended as the initial ADHD intervention. Consideration of pharmacotherapy follows if behavioral

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04. Suicidality and Self-Injury With Selective Serotonin Reuptake Inhibitors in Youth: Occurrence, Predictors, and Timing

Learning Objectives:

After completing this activity, the learner will be able to:

Examine the sensitivity and specificity of multiple symptoms and labs used in the diagnosis of myocarditis among patients taking clozapine.
Evaluate the evidence for the use of prophylactic fluoxetine after a stroke for improving neurologic outcomes and recovery rates as well as preventing depression.
Assess the relative efficacy and adverse event potential of methylphenidate vs alpha-adrenergic agonists in preschool children with ADHD.
Review recent research regarding the effect of antidepressant initiation on suicidal ideation.
Examine recent research regarding prognostic factors for recurrence for patients with first-episode psychosis.

Original Release Date: November 1, 2021

Review and Re-release Date: March 1, 2024

Expiration Date: April 1, 2025

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.