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The effects of long-acting stimulant and nonstimulant medications in children and adolescents with attention-deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials

dc.contributor.authorCerrillo-Urbina A.J.
dc.contributor.authorGarcía-Hermoso A.
dc.contributor.authorPardo-Guijarro M.J.
dc.contributor.authorSánchez-López M.
dc.contributor.authorSantos-Gómez J.L.
dc.contributor.authorMartínez-Vizcaíno V.
dc.date.accessioned2020-09-02T22:14:48Z
dc.date.available2020-09-02T22:14:48Z
dc.date.issued2018
dc.identifier10.1089/cap.2017.0151
dc.identifier.citation28, 8, 494-507
dc.identifier.issn10445463
dc.identifier.urihttps://hdl.handle.net/20.500.12728/3994
dc.descriptionObjective: The aim of this study was to assess the efficacy and safety of stimulant and nonstimulant medications in children and adolescents using as an outcome measure the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and to examine the effect of medications in different ADHD subtypes (i.e., inattention and hyperactivity/impulsivity). Methods: MEDLINE, Scopus, EMBASE, EBSCO (E-journal, CINAHL and SportDiscus), PUBMED, and The Cochrane Central Register of Controlled Trials databases were searched. Randomized controlled trials (RCTs) with parallel group or placebo-controlled studies comparing the effect of medications (stimulants or nonstimulants) in children and adolescents with ADHD were included. The main outcomes were the ADHD-RS-IV total score and subtypes (inattention and hyperactivity/impulsivity). Treatment-emergent adverse events (TEAEs) and secondary outcomes such as systolic and diastolic blood pressure, and pulse rate were considered. Results: The search strategy identified 15 RCTs, including a total of 4648 children and/or adolescents diagnosed with ADHD aged 6 to 17 years old. Overall, both stimulant and nonstimulant medications reduce the ADHD-RS-IV score with a standardized mean difference (SMD) of -0.70 (confidence interval [95% CI], -0.85 to -0.55); in subgroup analyses, the SMD was -0.83 (95% CI, -1.11 to -0.54) for stimulant medications and -0.58 (95% CI, -0.69 to -0.46) for nonstimulant medications. Similar results were observed in inattention and hyperactivity/impulsivity subtypes. The placebo group also showed a medium effect SMD of -0.68 (95% CI, -0.82 to -0.54). The most frequent TEAEs for stimulant and nonstimulant medications, respectively, were decreased appetite (28.6% and 14.2%) and somnolence (4.4% and 34.1%). Conclusions: These results suggest that both stimulant and nonstimulant medications mitigate ADHD symptoms in children and adolescents, although subgroup analyses suggest a greater effectiveness of stimulant medications. © Copyright 2018, Mary Ann Liebert, Inc., publishers.
dc.language.isoen
dc.publisherMary Ann Liebert Inc.
dc.subjectADHD
dc.subjecthyperactivity/impulsivity
dc.subjectinattention
dc.subjectpharmacological intervention
dc.subjectyouths
dc.subjectcentral stimulant agent
dc.subjectmethylphenidate
dc.subjectadolescent
dc.subjectattention deficit disorder
dc.subjectchild
dc.subjecthuman
dc.subjectimpulsiveness
dc.subjectmedication compliance
dc.subjectmeta analysis
dc.subjectrandomized controlled trial (topic)
dc.subjectAdolescent
dc.subjectAttention Deficit Disorder with Hyperactivity
dc.subjectCentral Nervous System Stimulants
dc.subjectChild
dc.subjectHumans
dc.subjectImpulsive Behavior
dc.subjectMedication Adherence
dc.subjectMethylphenidate
dc.subjectRandomized Controlled Trials as Topic
dc.titleThe effects of long-acting stimulant and nonstimulant medications in children and adolescents with attention-deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials
dc.typeArticle


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