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Introduction: Stimulants are used as first-line treatment for children with attention deficit hyperactivity disorder (ADHD), and their safety and efficacy are well established. Their most frequent adverse effects are sleep disturbance and decreased appetite which may limit optimal dosing and compliance. The aim of this study was to investigate the efficacy of mirtazapine on OROS methylphenidate (MPH) - induced weight loss and insomnia in children and adolescents with ADHD.
Methods: We reviewed the charts of children and adolescents diagnosed with ADHD and identified 18 individuals prescribed mirtazapine for weight loss and/or insomnia while on OROS – MPH treatment. Of these, 2 discontinued mirtazapine within the first week due to excessive daytime sedation.
Results: Mirtazapine was well tolerated by the remaining 16 subjects and no other side effects were reported. All subjects gained weight during concomitant mirtazapine treatment, with a mean gain of 2.1 kg. Fourteen of 16 children who had reported insomnia on MPH alone noted significant improvements in sleep after initiation of mirtazapine.
Conclusion: In this chart review, mirtazapine was found to be beneficial for weight loss and insomnia associated with MPH treatment in children and adolescents with ADHD.