According to the most recent National Institutes of Health Consensus Statement (1998), "attention deficit hyperactivity disorder is the most commonly diagnosed childhood behavioral disorder." A wide range of drugs are available to treat ADHD, with stimulant medications being the historically the treatment of choice. There are now many stimulants and multiple formulations of individual stimulants, on the market. Additionally, there are non-stimulant medications that are used to treat ADHD, including atomoxetine, atypical antipsychotics, bupropion, clonidine, and guanfacine. The purpose of this review is to evaluate the comparative evidence of benefits and harms of medications used to treat ADHD, with specific emphasis on evaluating the newer long-acting stimulant formulations and the nonstimulant medication atomoxetine relative to each other and the older immediate release stimulant medications. The review includes both children and adults.

Contents

• Introduction
  • Purpose and Limitations of Systematic Reviews
  • Scope and Key Questions
  • Inclusion Criteria
• Methods
  • Literature Search
  • Study Selection
  • Data Abstraction
  • Validity Assessment
  • Evidence Synthesis
• Results
  • Overview
  • Summary of Findings
  • Key Question 1. What is the comparative efficacy or effectiveness of different pharmacologic treatments for attention deficit disorders?
  • Key Question 2. Safety
  • Key Question 3. Subgroups
  • Limitations of this Review
• Summary
• References
• Appendix A. Glossary
• Appendix B. Scales used to assess efficacy and adverse events
• Appendix C. Search strategy: Update 3
• Appendix D. Methods used to assess quality of studies
• Appendix E. Excluded trials
• Appendix F. Previous systematic reviews
• Appendix G. Black box warnings of ADHD drugs approved by the US Food and Drug Administration
• Evidence Tables

Update 2: November 2007
Update 1: May 2006
Original Report: September 2005

The medical literature relating to this topic is scanned periodically. (See http://www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/methods.cfm for description of scanning process). Prior versions of this report can be accessed at the DERP website.

Suggested citation:

McDonagh MS, Christensen V, Peterson K, Thakurta S. Drug Class Review on Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder. 2009. http://www.ohsu.edu/drugeffectiveness/reports/final.cfm

This report reviews information about the comparative effectiveness and safety of drugs within a pharmaceutical class. The report is neither a usage guideline nor an endorsement or recommendation of any drug, use, or approach. Oregon Health & Science University does not endorse any guideline or recommendation developed by users of this report.