Pharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysis
Open accessAbstract
Our objective was to conduct a meta-analysis of therapeutic efficacy of pharmacological treatment of adult ADHD based on data from controlled clinical trials. We used the search engines PubMed and Medline to identify relevant clinical trials. Short-term studies with double-blind parallel-group design were selected for the analysis. Altogether, we identified 11 trials that met the criteria, and investigated a total of 1991 subjects, 694 and 1297 of whom were treated with placebo or active medication, respectively. In order to pool efficacy data from studies with different characteristics, including different number of participants, different trial duration and measures of efficacy, the statistical effect sizes for each study had to be calculated. Our findings showed that the pooled effect size across all treatments was in the medium-to-high range (Cohen's d=0.65, p<0.0001 vs. placebo), and the effect size for stimulants (Cohen's d=0.67, p<0.0001 vs. placebo) was somewhat higher than for non-stimulant medications (Cohen's d=0.59, p<0.0001 vs. placebo). The current database of controlled trials for adult ADHD is relatively small, and does not include data for many of the potentially important agents. In addition, effect-size estimates for different classes of medications (i.e. stimulant and non-stimulant medications) were based on separate studies; head-to-head comparisons of various agents are severely lacking. Nonetheless, results of this meta-analysis across all ADHD medications in adult subjects demonstrated statistically significant and clinically robust improvement in symptom severity compared to placebo treatment.
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An increasing number of studies in adults demonstrate a similar clinical response to that seen in children.
“An increasing number of studies in adults demonstrate a similar clinical response to that seen in children [32,236-239].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [237]
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- Authors
- Mészáros, Á., Czobor, P., Bálint, S., Komlósi, S., Simon, V., & Bitter, I.
- Affiliations
- Semmelweis University (HU)
- Corresponding author
- Mészáros, Ágnes
- Venue
- The International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-07-07
- Volume
- 12
- Issue
- 08
- Pages
- 1137
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- OpenAlex
- W2001828543
- Cited by
- 138
- References
- 62
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 7 · 2023: 2 · 2022: 7 · 2021: 10 · 2020: 9 · 2019: 4 · 2018: 6 · 2017: 10 · 2016: 9 · 2015: 9 · 2014: 11 · 2013: 9 · 2012: 14
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
- Keywords
- adult ADHD, pharmacotherapy, stimulant medication, non-stimulant medication, placebo comparison, symptom severity, treatment efficacy, effect size
- MeSH terms
- Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Clinical Trials as Topic, Combined Modality Therapy, Female, Humans, Male, Treatment Outcome
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