COMPLETED ADOPTED PROJECT: Comparing pharmacological and non-pharmacological interventions for adults with Attention-Deficit/Hyperactivity Disorder (ADHD): systematic review and network meta-analysis
Chief Investigator: Professor Samuele Cortese – University of Southampton
Project Team Members: Professor Andrea Cipriani – University of Oxford, Associate Professor Corentin Gosling – University of Paris Nanterre, France, Dr Luis Faraht – University of São Paulo, Brazil / Yale University Child Study Center, USA, Dr Cinzia Del Giovane – University of Modena and Reggio, Italy
Start Date: 1st March 2022
End Date: 28th February 2024
Background:
It is currently unclear how different treatment options for preschool children with ADHD compare with each other in terms of efficacy and safety. We will use data from available randomised controlled trials (RCTs) and apply an advanced and innovative statistical approach (network meta-analysis) to answer this question. The project started in 2022.
Expected outcomes:We will understand how pharmacological and non-pharmacological interventions (including behaviour intervention, family-based systematic approaches and dietetic interventions) compare with each other in terms of their beneficial effects on ADHD symptoms and safety.
What did we find out?
We found that Stimulant medications and atomoxetine are the only treatments that clearly help reduce the main symptoms of ADHD in the short term, based on both what patients say and what doctors observe.
However, people were less likely to stick with atomoxetine than with a placebo (a dummy pill). These medications didn’t show clear benefits for other important things like improving quality of life, and we don’t know much about how well they work in the long run. Non-medication treatments had mixed results depending on who was doing the rating.
This study gives the most complete picture so far of how different treatments for adult ADHD compare to each other. It can help guide treatment choices, but those choices should always be based on a careful look at both the benefits and risks — and on what matters most to the individual.
•The study is already informing clinical guidelines, e.g., the ongoing guidelines from APOSARD (USA).
What will we do Next?
Going forwards we will:
• Contact guideline bodies in the UK and abroad to bring the network meta-analysis to their attention.
• Include the results of the network meta-analysis in a large-scale umbrella review on pharmacological and non- pharmacological treatments for ADHD across the lifespan, and to create a platform to disseminate the findings in a user-friendly way to inform service users, clinicians, and guideline developers.
