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Several Treatments Effective in Youth With ADHD, but Evidence Strongest for Medication
While treatments that improve attention-deficit/hyperactivity disorder (ADHD) in children and adolescents are diverse and growing, medications have the strongest evidence base for improved outcomes. Researchers published their findings from a systematic review in Pediatrics.
“Nonetheless, the body of evidence provides youth with ADHD, their parents, and health care providers with options,” wrote corresponding author Susanne Hempel, PhD, of the Southern California Evidence Review Center at the University of Southern California, Los Angeles, California, and study coauthors.
The systematic review included 312 studies of controlled ADHD treatment evaluations in youth. Results from the studies were reported in a total 540 publications.
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The investigation revealed compelling evidence for numerous treatments. Helpful interventions include both stimulant and nonstimulant medications, youth-directed psychosocial treatments, parent support, neurofeedback, and cognitive training, researchers reported. Nonmedication interventions, however, appeared to have weaker effects on ADHD symptoms than medications.
Stimulant and nonstimulant norepinephrine reuptake inhibitors showed similar effectiveness and rates of side effects, including appetite suppression, separately and in head-to-head trials. According to the study, the review’s findings support clinical guidelines advising treatment with medication approved by the US Food and Drug Administration (FDA) for youth older than 6 years with ADHD.
“Furthermore, FDA-approved medications have been shown to significantly improve broadband measures, and nonstimulant medications have been shown to improve disruptive behaviors,” researchers wrote, “suggesting their clinical benefits extend beyond improving only ADHD symptoms.”
Neurofeedback and cognitive training improved ADHD symptoms but with a low strength of evidence. Dietary interventions and nutritional supplements also improved ADHD symptoms and disruptive behaviors, but reviewers could not identify systematic benefits with specific supplements.
“Future studies of psychosocial, parent, school-based, neurofeedback, and nutritional treatments should employ more uniform interventions and study designs that provide a higher strength of evidence for effectiveness, including active attention comparators and effective blinding of outcome assessments,” researchers wrote.
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