Efficacy and Tolerability of Different Interventions in Children and Adolescents with Attention Deficit Hyperactivity Disorder
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BACKGROUND: Our study is an analysis of multiple publications involving assessing the comparable efficacy and tolerability of six interventions, which are lisdexamfetamine dimesylate (LDX), atomoxetine (ATX), methylphenidate (MPH), clonidine hydrochloride (CLON), guanfacine extended release (GXR), and bupropion, for young patients (6-18 years old) suffering from attention deficit hyperactivity disorder (ADHD). METHODS: A conventional meta-analysis (MA) was performed to give direct comparisons and a network meta-analysis (NMA) was used to show the combination of direct and indirect evidence. Ranking preference for all the interventions under a certain outcome was given by the surface of cumulative ranking curve area (SUCRA). RESULTS: Overall, 15,025 participants from 73 studies were involved in our analysis. In the pairwise MA, LDX was associated with less withdrawal than ATX for lack of efficacy. MPH showed less effectiveness than LDX according to ADHD Rating Scale score. Based on the analysis of our NMA, significant results of efficacy that LDX is a competitive drug were observed when evaluating LDX in comparison with other drugs except for CLON. ATX and GXR presented higher rates of abdominal pain morbidity versus inactive treatment. CONCLUSION: The stimulants LDX and MPH are still highly recommended because they are highly effective and are tolerated well by patients. Among the non-stimulants, CLON can be taken into consideration for its appreciable effectiveness and tolerability. ATX and GXR can be seen as moderate choices.
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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”
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Cheng, H., Elbers, R. G., Higgins, J. P. T., Taylor, A., MacArthur, G. J., McGuinness, L. A., Dawson, S., López-López, J. A., Cowlishaw, S., Hickman, M., et al. (2017) · Systematic Reviews · doi:10.1186/s13643-017-0462-2 · Cited by 10 · see citing works
Setyawan, J., Yang, H., Cheng, D., Cai, X., Signorovitch, J., Xie, J., & Erder, M. H. (2015) · Value in Health · doi:10.1016/j.jval.2015.06.005 · Cited by 8 · see citing works
Wehmeier, P. M., Kipp, L., Banaschewski, T., Dittmann, R., & Schacht, A. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712456739 · Cited by 7 · see citing works
Flagged first, then by citations
1 of the 87 references couldn’t be matched to a known paper.
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
Treatment strategies for ADHD: an evidence-based guide to select optimal treatment
Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0116-3 · Cited by 303 · see citing works
Correll, C. U., Cortese, S., Croatto, G., Monaco, F., Krinitski, D., Arrondo, G., Ostinelli, E. G., Zangani, C., Fornaro, M., Estradé, A., et al. (2021) · World Psychiatry · doi:10.1002/wps.20881 · Cited by 156 · see citing works
Clinical and Experimental Factors Influencing the Efficacy of Neurofeedback in ADHD: A Meta-Analysis
Bussalb, A., Congedo, M., Barthélemy, Q., Ojeda, D., Acquaviva, E., Delorme, R., & Mayaud, L. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00035 · Cited by 60 · see citing works
Lisdexamfetamine Dimesylate: A Review in Paediatric ADHD
Frampton, J. E. (2018) · Drugs · doi:10.1007/s40265-018-0936-0 · Cited by 34 · see citing works
Meta-Review: Network Meta-Analyses in Child and Adolescent Psychiatry
Cortese, S., Tomlinson, A., & Cipriani, A. (2018) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.07.891 · Cited by 25 · see citing works
Zheng, X., Shen, L., Jiang, L., Shen, X., Xu, Y., Yu, G.-J., & Wang, Y. (2020) · Frontiers in Pediatrics · doi:10.3389/fped.2020.486353 · Cited by 18 · see citing works
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Du, Y., Ke, X., Gao, F., Chen, W., Wu, W., Li, Y., Du, L., Ye, Y., Zhu, H., Cai, L., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3022726/v1
- Authors
- Luan, R., Mu, Z., Yue, F., & He, S.
- Affiliations
- Qingdao University (CN)
- Corresponding author
- He, Shaoying
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2017-11-13
- Volume
- 8
- Pages
- 229-229
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC5694170
- OpenAlex
- W2770081088
- Cited by
- 11
- References
- 87
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 4
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- 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
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- attention deficit hyperactivity disorder, children and adolescents, lisdexamfetamine dimesylate, atomoxetine, methylphenidate, clonidine, guanfacine extended release, bupropion, stimulant efficacy, tolerability, abdominal pain, ADHD Rating Scale
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 ›
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