Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review

@article{DeCrescenzo2016PharmacologicalAN,
  title={Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review},
  author={Franco De Crescenzo and Samuele Cortese and Nicoletta Adamo and Luigi Janiri},
  journal={Evidence-Based Mental Health},
  year={2016},
  volume={20},
  pages={11 - 4}
}
Attention-deficit/hyperactivity disorder (ADHD) is characterised by a persistent and impairing pattern of inattention and/or hyperactivity/impulsivity and it is one of the most common neuropsychiatric conditions. Evidence about interventions of adults with ADHD is growing rapidly and clinicians need a reliable summary of all the best available information in order to better inform their daily practice. We searched MEDLINE, PubMed, PsycINFO and Cochrane databases until 31 May 2016 for systematic… 

Psychological Treatments in Adult ADHD: A Systematic Review

TLDR
Findings indicated support for the effectiveness of Mindfulness, Dialectical Behavior Therapy and Neurofeedback, and other types of interventions also demonstrated effectiveness; however, support was limited due to lack of available research and methodological rigor.

the of Pharmacological, Alternative /Complementary Interventions in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: Meta-regression Approach

TLDR
Psychostimulant therapy surpassed non-stimulant pharmacotherapy and alternative/complement intervention and appears to be similar in efficacy according to this meta-regression.

Attention-Deficit/Hyperactivity Disorder in Looked-After Children: a Systematic Review of the Literature

TLDR
The vast majority of the retained studies are from the USA and show rates of ADHD and of its pharmacological treatment substantially higher in LAC than those reported in national estimates.

Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD)

TLDR
This paper reviews randomized active comparator-controlled or placebo-controlled trials evaluating the use of pharmacotherapy in patients with ADHD and SUD and explores the divergences in treatment response of different ADHD subtypes in different subtypes of SUD.

Exploring the Effects of Pharmacological, Psychosocial, and Alternative/Complementary Interventions in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Meta-Regression Approach

TLDR
Psychostimulant therapy surpassed non-stimulant pharmacotherapy and alternative/complement intervention and appears to be similar in efficacy according to this meta-regression.

Effects of neurofeedback versus methylphenidate for the treatment of ADHD: systematic review and meta-analysis of head-to-head trials

TLDR
At the study follow-up, MPH was superior to NF in some outcomes, but results were inconsistent across raters, and further high quality studies are needed to assess the comparative efficacy and acceptability of NF and MPH in individuals with ADHD.

Prescription psychostimulants for the treatment of stimulant use disorder: a systematic review and meta-analysis

TLDR
Prescription psychostimulants, particularly prescription amphetamines given in robust doses, have a clinically significant beneficial effect to promote abstinence in the treatment of individuals with PSUD, specifically the population with cocaine use disorder.

Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis

Reviewing the role of emerging therapies in the ADHD armamentarium

TLDR
A robust pipeline of stimulants and nonstimulants in development are found, formulated to optimize onset and duration of effect, alter the time of administration, obviate the need to swallow whole capsules or tablets and to deter abuse.
...

References

SHOWING 1-10 OF 71 REFERENCES

Alternative pharmacological strategies for adult ADHD treatment: a systematic review

TLDR
Among alternative compounds, amphetamines have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension), and antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of effective but should be avoided in patients with comorbid bipolar disorder.

Are there any potentially dangerous pharmacological effects of combining ADHD medication with alcohol and drugs of abuse? A systematic review of the literature

TLDR
There was only a minimal increase in side-effects when ADHD medication (therapeutic doses) was taken with alcohol and none of the reviewed studies showed severe sequelae among those who had overdosed on ADHD medication and other coingestants, including alcohol.

Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).

TLDR
Methylphenidate may improve teacher-rated ADHD symptoms and downgraded evidence according to the Grades of Recommendation, Assessment, Development and Evaluation approach for high risk of bias, imprecision, indirectness, heterogeneity and publication bias is assessed.

Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults.

TLDR
Low- to very low-quality evidence is found suggesting that amphetamines reduced the severity of ADHD symptoms as rated by clinicians, and no studies that had low risk of bias in all domains of the Cochrane 'Risk of bias' tool are found.

Treatment discontinuation with methylphenidate in adults with attention deficit hyperactivity disorder: a meta-analysis of randomized clinical trials

TLDR
Methylphenidate was more efficacious than placebo for reducing ADHD symptoms and it was associated with a higher proportion of patients dropping out due to adverse effects, but more attention should be given to the endpoint “all-cause treatment discontinuation” when making regulatory decisions and developing clinical guidelines involving the treatment of ADHD in adulthood.

Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults.

TLDR
The three amphetamine derivatives investigated (dextroamphetamine, lisdexamphetamine and mixed amphetamine salts) were all efficacious for reducing ADHD symptoms, but MAS also increased retention in treatment, and amphetamines improved short-term ADHD symptom severity.

Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments.

TLDR
Better evidence for efficacy from blinded assessments is required for behavioral interventions, neurofeedback, cognitive training, and restricted elimination diets before they can be supported as treatments for core ADHD symptoms.

Pharmacological treatment of attention deficit hyperactivity disorder with co-morbid drug dependence

TLDR
While pharmacological interventions improved ADHD symptoms, no beneficial effect on drug abstinence or on treatment discontinuation was noted and the strength of the recommendation of pharmacological treatment for co-occurring ADHD and SUD is modest.

Efficacy of Methylphenidate for Adults with Attention-Deficit Hyperactivity Disorder

TLDR
This study shows that methylphenidate improves ADHD symptoms in adults in a dose-dependent fashion, and appears to be reduced in patients with co-morbid SUD.

Efficacy of atomoxetine in adults with attention deficit hyperactivity disorder: An integrated analysis of the complete database of multicenter placebo-controlled trials

TLDR
Overall, ATX had a clinically significant effect in adults with ADHD, with reductions in core symptoms and clinically meaningful responder rates.
...