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ADHD in children and adolescents
Daphne Keen1, Irene Hadijikoumi
1Department of Developmental Paediatrics, St George's Hospital, London, UK.
BMJ Clinical Evidence
|May 19, 2009
Summary
This review examines pharmacological, psychological, and combination treatments for attention deficit hyperactivity disorder (ADHD) in children and adolescents. It synthesizes evidence on the effectiveness and safety of various interventions for ADHD management.
Area of Science:
- Pediatric Neurology
- Psychiatry
- Evidence-Based Medicine
Background:
- Prevalence of attention deficit hyperactivity disorder (ADHD) in school children varies widely (1.7%-16.0%), with no objective diagnostic tests available.
- ADHD diagnosis is clinical, often co-occurring with other conditions, necessitating comprehensive treatment evaluations.
- Existing prevalence estimates for ADHD differ based on diagnostic criteria and sampled populations.
Purpose of the Study:
- To systematically review the effects of pharmacological treatments for ADHD in children and adolescents.
- To evaluate the efficacy and safety of psychological interventions for ADHD.
- To assess combination treatments for ADHD, including both drug and behavioral therapies.
Main Methods:
- Systematic review of 34 studies including systematic reviews, randomized controlled trials (RCTs), and observational studies.
- Searched major databases (Medline, Embase, Cochrane Library) up to June 2007.
- Included harms alerts from regulatory agencies like the FDA and MHRA; employed GRADE evaluation for evidence quality.
Main Results:
- The review identified and evaluated evidence for multiple ADHD interventions.
- Included interventions encompass pharmacotherapies (e.g., methylphenidate, atomoxetine) and psychological/behavioral treatments.
- GRADE evaluation was used to assess the quality of evidence for each intervention.
Conclusions:
- Information on the effectiveness and safety of various ADHD treatments is presented.
- Interventions reviewed include atomoxetine, bupropion, clonidine, dexamfetamine sulphate, homeopathy, methylphenidate, modafinil, omega-3 fatty acids, and psychological/behavioral therapies.
- The review covers monotherapies and combination treatments for pediatric ADHD.
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