Safety of Treatments for ADHD in Adults: Pairwise and Network Meta-Analyses

J Atten Disord. 2019 Jan;23(2):111-120. doi: 10.1177/1087054717696773. Epub 2017 Apr 3.

Abstract

Objective: The aim of the study was to analyze evidence comparing the profile of drugs used to treat ADHD in adult patients.

Method: Systematic searches were conducted in electronic databases. Randomized, double-blind, parallel controlled trials that evaluated the safety of drugs in ADHD were included. The statistical analyses were conducted by pairwise meta-analyses and mixed treatment comparison (MTC).

Results: Ten ( n = 3006) trials were included in the analyses. We observed statistical differences for the following outcomes: decreased appetite between atomoxetine and placebo (odds ratio [OR] = 0.15, 95% credibility interval [CrI] = [0.05, 0.38]) and extended-release mixed amphetamine salts and placebo (OR = 0.06, 95% CrI = [0.00, 0.51]); insomnia between atomoxetine and placebo (OR = 0.48, 95% CrI = [0.27, 0.88]) and extended-release mixed amphetamine salts and placebo (OR = 0.23, 95% CrI = [0.06, 0.76]); sleepiness between atomoxetine and methylphenidate OROS (OR = 0.24, 95% CrI = [0.06, 0.97]); and decreased libido between atomoxetine and placebo (OR = 0.28, 95% CrI = [0.08, 0.90]).

Conclusion: It was possible to generate evidence about the safety profile of different ADHD drugs.

Keywords: ADHD; adult ADHD treatment; decision making; review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adrenergic Uptake Inhibitors / adverse effects
  • Adrenergic Uptake Inhibitors / therapeutic use*
  • Adult
  • Amphetamine / adverse effects
  • Amphetamine / therapeutic use
  • Atomoxetine Hydrochloride / adverse effects
  • Atomoxetine Hydrochloride / therapeutic use
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / therapeutic use*
  • Databases, Factual
  • Humans
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use
  • Network Meta-Analysis
  • Odds Ratio
  • Sleep Initiation and Maintenance Disorders / chemically induced
  • Treatment Outcome
  • Wakefulness / drug effects*

Substances

  • Adrenergic Uptake Inhibitors
  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride
  • Amphetamine