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Meta-analysis / Everyday Life / kids + teens + adults

How well ADHD medication works, according to the pooled trials

A network meta-analysis in The Lancet Psychiatry compared medications across children, adolescents and adults on the same footing.

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The short version

Meta-analysis · kids + teens + adults · 2018

The authors pooled randomised trials of ADHD medications and compared them indirectly against each other.

Stimulants came out strongest on short-term core symptoms in every age band studied.

The trials are mostly short, and tolerability differs from efficacy.

01

What they studied

  • Published and unpublished randomised controlled trials of pharmacological treatments for ADHD were pooled into a network meta-analysis.
  • Outcomes were clinician-rated and teacher- or self-rated core symptoms, plus tolerability, analysed separately for children and adolescents and for adults.
02

What they found

  • Methylphenidate in children and adolescents, and amphetamines in adults, had the best balance of efficacy and tolerability at the group level.
  • Non-stimulant options were effective but with smaller average effects.
  • Effects on clinician-rated symptoms were generally larger than on teacher-rated symptoms.
03

Why it matters

  • By mental-health standards the short-term evidence base here is unusually strong, which is worth knowing if medication is on the table for you.
  • It also shows what medication doesn't do: it doesn't build systems, repair shame, or organise a kitchen.
04

What it doesn't mean

  • Most included trials were short-term. This is not evidence about years of use.
  • Average effects say nothing about how one person will respond, or about side effects they'll experience.
  • Nothing here is medical advice. Prescribing decisions belong with your clinician.

The bigger picture

Well established for short-term symptom outcomes; genuinely uncertain for long-term functional outcomes, where the evidence remains thin.

EvidenceStrong

Original research

Authors
Cortese, S., Adamo, N., Del Giovane, C., and colleagues
Study title
Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis
Journal
The Lancet Psychiatry
Year
2018
Study design
Systematic review and network meta-analysis of randomised controlled trials
DOI
10.1016/S2215-0366(18)30269-4
View original study

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