AHRQ
ADHD treatment: Evidence limited on head-to-head comparisons between stimulants and nonstimulants
Key points on treatment and monitoring from AHRQ's systematic review of evidence on attention deficit hyperactivity disorder (ADHD) in children and adolescents:
Treatment
- Several modalities improve core ADHD symptoms compared with controls such as placebo, including FDA-approved medications and psychosocial interventions, with high or moderate strength of evidence.
- FDA-approved stimulants (methylphenidate, amphetamine, etc.) and non-stimulant (atomoxetine, alpha agonist, etc.) medications had the strongest evidence across interventions for significantly improving ADHD symptoms and additional outcomes, including broadband measures and functional impairment.
- Head-to-head comparisons didn’t detect statistically significant differences between stimulant and non-stimulant medications for most effectiveness outcomes and adverse events.
- There was little evidence that combination therapies of medication plus psychosocial therapies produce better results than medication alone, but existing research evaluated unique combinations of intervention components.
- Despite the large body of research, comparative effectiveness and safety information is limited, and more research is needed to support choosing between treatments.
- Data were insufficient to assess the effect of co-occurring disorders on treatment effects.
- There were too few studies reporting on diversion to quantify the risk of diversion of pharmacological treatment.
Monitoring
- Very few monitoring studies have been reported, and more research is needed on how youth with ADHD should be monitored over time.
- Different assessment modalities may provide valid but different perspectives, and more than a single assessment modality may be required for comprehensive and effective monitoring of ADHD outcomes over time.
Source:
Systematic Review: ADHD Diagnosis and Treatment in Children and Adolescents. Content last reviewed November 2024. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. https://effectivehealthcare.ahrq.gov/products/attention-deficit-hyperactivity-disorder/research