scholarly journals A review of Cochrane reviews on pharmacological treatment for attention deficit hyperactivity disorder

2021 ◽  
Vol 15 (4) ◽  
pp. 421-427
Author(s):  
Giovanna Marcílio Santos ◽  
Elaine Marcílio Santos ◽  
Gustavo Duarte Mendes ◽  
Yara Dadalti Fragoso ◽  
Mariani Rafaela Souza ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Adverse Events ◽  
Children And Adolescents ◽  
Systematic Reviews ◽  
Attention Deficit ◽  
Randomized Clinical Trials ◽  
Placebo Treatment ◽  
Hyperactivity Disorder ◽  
Positive Effects ◽  
Cochrane Reviews

ABSTRACT. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent childhood psychiatric problems. Objective: The objective of this study was to identify, synthesize the results, and critically evaluate all Cochrane systematic reviews (SRs) on the pharmacological interventions for children and adolescents (up to age 18) diagnosed with ADHD. Methods: The search was performed in the Cochrane Database of Systematic Reviews (via Wiley) in July 2020. Results: The search strategy resulted in four SRs of high methodological quality, analyzing 51 randomized clinical trials (9,013 participants). Compared to placebo, treatment with tricyclic antidepressants (TCAs) (desipramine), amphetamine, and methylphenidate showed improvement in symptoms such as difficulty concentrating, impulsivity, and hyperactivity in the short term (up to 6 months). There was an increase in the occurrence of adverse events, such as reduced appetite, difficulty sleeping, and abdominal pain. Insufficient evidence was found to support the effects of supplementation with polyunsaturated fatty acids. Conclusions: The use of TCAs, amphetamine, and methylphenidate in children and adolescents with ADHD seems to present positive effects and higher rates of minor adverse events when compared to placebo.

Attention Deficit Hyperactivity Disorder

2018 ◽  
Author(s):  
Steven W. Evans ◽  
Julie S. Owens ◽  
W. John Monopoli ◽  
Kari Benson
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Randomized Clinical Trials ◽  
Evidence Base ◽  
Future Research ◽  
Hyperactivity Disorder ◽  
New Findings ◽  
Assessment And Treatment ◽  
Effective Assessment

Youth with attention deficit hyperactivity disorder experience impairment across multiple domains of functioning, with the characteristics changing with age. Thus, assessment and treatment must be appropriate for the home and school and relevant to the child’s developmental level. This chapter reviews effective assessment strategies for use with children and adolescents. Psychosocial treatments for children and adolescents are discussed separately, as the approaches with each group differ substantially. For children, strategies with a strong evidence base are described, and innovations and treatment modifications that have been examined recently are showcased. For adolescents, the results of the few randomized clinical trials conducted with this population are reviewed. A theoretical model for how to sequence treatments (i.e., intervention, medication, accommodations) for youth is referenced, and two case studies highlight this model, as well some of the new findings described in this chapter. Implications and recommendations for future research and practice are provided.

scholarly journals Does Methylphenidate Work in Children and Adolescents with Attention Deficit Hyperactivity Disorder?

2021 ◽  
Vol 13 (3) ◽  
pp. 434-443
Author(s):  
Johanne Pereira Ribeiro ◽  
Emma Jasmine Arthur ◽  
Christian Gluud ◽  
Erik Simonsen ◽  
Ole Jakob Storebø
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Clinical Trials ◽  
Children And Adolescents ◽  
Systematic Reviews ◽  
Attention Deficit ◽  
Cochrane Review ◽  
Field Method ◽  
Randomised Clinical Trials ◽  
Hyperactivity Disorder ◽  
Meta Analyses

Objective: Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder diagnosed in increasing proportions of children and adolescents. The psychostimulant methylphenidate has been considered the first-line pharmacological treatment for children and adolescents with ADHD for more than 60 years. Considering recent publications on methylphenidate for ADHD, we here give an overview of its effects in children and adolescents with ADHD, elicited by a well-disputed Cochrane review and narratively synthesise the evidence in the field. Method: We searched for systematic reviews and meta-analyses that investigated methylphenidate as an intervention for children and adolescence with ADHD compared with placebo or no treatment. We assessed the quality of the evidence using AMSTAR II. Results: We found 24 eligible systematic reviews and meta-analyses of which 11 were rated as high- quality evidence according to AMSTAR II. The evidence claiming that methylphenidate is beneficial in treating children and adolescents with ADHD was of very low certainty. The underreporting of adverse events in randomised clinical trials may impede an adequate depiction of the balance between benefits and harms. Conclusions: It appears that there is uncertain evidence on group-level to support the claim that methylphenidate is beneficial in treating children and adolescents with ADHD. Future randomised clinical trials and systematic reviews should include individual participant data, which would allow us to assess intervention effects across modifiers, like age, sex, ADHD subtypes, comorbidities, and dose.

scholarly journals Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 10 (2) ◽  
pp. 79 ◽  
Author(s):  
Yanni Liu ◽  
Gregory L. Hanna ◽  
Barbara S. Hanna ◽  
Haley E. Rough ◽  
Paul D. Arnold ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Child Behavior Checklist ◽  
Performance Monitoring ◽  
Longitudinal Design ◽  
Flanker Task ◽  
Developmental Trajectory ◽  
Time Variability ◽  
Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.

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