An Evaluation on the Efficacy and Safety of Treatments for Attention Deficit Hyperactivity Disorder in Children and Adolescents: a Comparison of Multiple Treatments
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders. We carried out this comparison of multiple treatments based on sufficient data in attempt to evaluate the efficacy and safety of ADHD medication for children and adolescents. PubMed, Embase and the Cochrane Database were used to search for relevant articles. Changes in the ADHD Rating Scale (ADHD-RS) scores and the Conners' Parent Rating Scale-Revised (CPRS) scores were used as outcomes for efficacy. Withdrawals due to all-cause, adverse effects and lack of efficacy were defined as primary outcomes evaluating the safety of such medications. Both pair-wise and network meta-analyses were performed. Efficacy and safety of atomoxetine (ATX), bupropion (BUP), clonidine hydrochloride (CLON), guanfacine extended release (GXR), lisdexamfetamine dimesylate (LDX), and methylphenidate (MPH) were evaluated. LDX has the highest efficacy and a relatively lower rate of adverse effects compared to BUP, CLON and GXR. MPH has the lowest incidence rate of adverse effects and takes second place concerning ADHD-RS scores and third place concerning CPRS scores. ATX has the lowest incidence rate of all-cause withdrawals. The efficacy of ATX seems, however, to be lower than CLON, GXR, LDX and MPH. Adversely, BUP has the highest incidence rate of withdrawals and the second highest probability of causing adverse effects as well as lack of efficacy; therefore it should not be recommended as a treatment…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Previous network meta-analyses in ADHD have focused on either children and adolescents or adults only, have typically compared only a few drugs, or have addressed exclusively the safety of treatments.
“Previous network meta-analyses in ADHD have focused on either children and adolescents19, 20, 21, 22, 23, 24 or adults only,25, 26, 27, 28 have typically compared only a few drugs,24, 25, 27, 29 or have addressed exclusively the safety of treatments.26”
Cites
Kelsey, D. K., Sumner, C. R., Casat, C. D., Coury, D. L., Quintana, H., Saylor, K. E., Sutton, V. K., Gonzales, J., Malcolm, S. K., Schuh, K. J., et al. (2004) · Pediatrics · doi:10.1542/peds.114.1.e1 · Cited by 464 · see citing works
Spencer, T., Heiligenstein, J. H., Biederman, J., Faries, D. E., Kratochvil, C. J., Conners, C. K., & Potter, W. Z. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n1209 · Cited by 333 · see citing works
Effects of Atomoxetine and Methylphenidate on Sleep in Children With ADHD
Sangal, R. B., Owens, J., Allen, A. J., Sutton, V., Schuh, K., & Kelsey, D. (2006) · Sleep · doi:10.1093/sleep/29.12.1573 · Cited by 214 · see citing works
Weiss, M., Tannock, R., Kratochvil, C., Dunn, D., Velez-Borras, J., Thomason, C., Tamura, R., Kelsey, D., Stevens, L., & Allen, A. J. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000163280.47221.c9 · Cited by 147 · see citing works
Jain, R., Segal, S., Kollins, S. H., & Khayrallah, M. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.11.005 · Cited by 142 · see citing works
The Atomoxetine ADHD and Comorbid MDD Study Group:, Bangs, M. E., Emslie, G. J., Spencer, T. J., Ramsey, J. L., Carlson, C., Bartky, E. J., Busner, J., Duesenberg, D. A., Harshawat, P., et al. (2007) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2007.0066 · Cited by 103 · see citing works
Thurstone, C., Riggs, P. D., Salomonsen-Sautel, S., & Mikulich-Gilbertson, S. K. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.02.013 · Cited by 96 · see citing works
Bangs, M. E., Hazell, P., Danckaerts, M., Hoare, P., Coghill, D. R., Wehmeier, P. M., Williams, D. W., Moore, R. J., Levine, L., & for the Atomoxetine ADHD/ODD Study Group (2008) · Pediatrics · doi:10.1542/peds.2006-1880 · Cited by 79 · see citing works
Kollins, S. H., López, F. A., Vince, B. D., Turnbow, J. M., Farrand, K., Lyne, A., Wigal, S. B., & Roth, T. (2011) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2010.0064 · Cited by 53 · see citing works
Roskell, N. S., Setyawan, J., Zimovetz, E. A., & Hodgkins, P. (2014) · Current Medical Research and Opinion · doi:10.1185/03007995.2014.904772 · Cited by 42 · see citing works
Takahashi, M., Takita, Y., Yamazaki, K., Hayashi, T., Ichikawa, H., Kambayashi, Y., Koeda, T., Oki, J., Saito, K., Takeshita, K., et al. (2009) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2008.0154 · Cited by 36 · see citing works
Coghill, D. R., Banaschewski, T., Lecendreux, M., Zuddas, A., Dittmann, R. W., Otero, I. H., Civil, R., Bloomfield, R., & Squires, L. A. (2014) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-013-0421-y · Cited by 33 · see citing works
Findling, R. L., McBurnett, K., White, C., & Youcha, S. (2014) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2013.0103 · Cited by 32 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Cortese, S., Adamo, N., Del Giovane, C., Mohr-Jensen, C., Hayes, A. J., Carucci, S., Atkinson, L. Z., Tessari, L., Banaschewski, T., Coghill, D., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30269-4 · Cited by 1,402 · see citing works
Fargason, R. E., Fobian, A. D., Hablitz, L. M., Paul, J. R., White, B. A., Cropsey, K. L., & Gamble, K. L. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.03.004 · Cited by 64 · see citing works
- Authors
- Li, Y., Gao, J., He, S., Zhang, Y., & Wang, Q.
- Affiliations
- Henan University (CN)
- Corresponding author
- Li, Ying
- Gao, Jie
- Venue
- Molecular Neurobiology
- Published
- 2016-10-13
- Volume
- 54
- Issue
- 9
- Pages
- 6655-6669
- ISSN
- 0893-7648 (ISSN-L)
- 1559-1182
- OpenAlex
- W2531524018
- Cited by
- 26
- References
- 13
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 6 · 2017: 2
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Molecular Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, ADHD medication, children and adolescents, atomoxetine, bupropion, clonidine, guanfacine extended release, lisdexamfetamine dimesylate, methylphenidate, treatment efficacy, adverse effects, drug withdrawal
- MeSH terms
- Atomoxetine Hydrochloride, Lisdexamfetamine Dimesylate, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Clonidine, Dextroamphetamine, Female, Humans, Male, Methylphenidate, Treatment Outcome, Drug-Related Side Effects and Adverse Reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review