Core ADHD symptom improvement with atomoxetine versus methylphenidate: a direct comparison meta-analysis
Philip L Hazell1, Michael R Kohn, Ruth Dickson
1Discipline of Psychological Medicine, Concord Clinical School, The University of Sydney, Australia. philip.hazell@sswahs.nsw.gov.au
Journal of Attention Disorders
|September 15, 2010
Summary
Atomoxetine and methylphenidate show similar effectiveness in treating attention deficit hyperactivity disorder (ADHD) core symptoms in children and adolescents. This meta-analysis found comparable response rates after six weeks of treatment.
Area of Science:
- Pediatric Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Previous research comparing atomoxetine and methylphenidate for attention deficit hyperactivity disorder (ADHD) symptom management has yielded inconsistent results.
- This study addresses the equivocal findings by directly comparing the efficacy of these two common ADHD treatments.
Purpose of the Study:
- To conduct a noninferiority meta-analysis comparing the core ADHD symptom response between atomoxetine and methylphenidate in pediatric populations.
- To determine if atomoxetine is not unacceptably less effective than methylphenidate for treating ADHD.
Main Methods:
- A meta-analysis of randomized, controlled trials with a 6-week duration was performed.
- Response was defined as a ≥40% reduction in ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored (ADHDRS) total scores.
- Noninferiority was assessed using a margin of -15%.
Main Results:
- Seven studies including 1,368 patients met the inclusion criteria.
- After six weeks, response rates were 53.6% for atomoxetine (n=811) and 54.4% for methylphenidate (n=557).
- Atomoxetine demonstrated noninferiority to methylphenidate, with an absolute difference of -0.9% (95% CI -9.2% to 7.5%).
Conclusions:
- Atomoxetine and methylphenidate exhibit comparable efficacy in reducing core ADHD symptoms in children and adolescents after six weeks of treatment.
- The findings suggest that atomoxetine is a viable alternative to methylphenidate for ADHD symptom management in this age group.
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