Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults

Abstract

BackgroundAttention deficit hyperactivity disorder (ADHD) is a childhood-onset disorder characterised by inattention, hyperactivity, and impulsivity. ADHD can persist into adulthood and can affects individuals' social and occupational functioning, as well as their quality of life and health. ADHD is frequently associated with other mental disorders such as substance use disorders and anxiety and affective disorders. Amphetamines are used to treat adults with ADHD, but uncertainties about their efficacy and safety remain. ObjectivesTo examine the efficacy and safety of amphetamines for adults with ADHD. Search methodsIn August 2017, we searched CENTRAL, MEDLINE, Embase, PsycINFO, 10 other databases, and two trials registers, and we ran citation searches for included studies. We also contacted the corresponding authors of all included studies, other experts in the field, and the pharmaceutical company, Shire, and we searched the reference lists of retrieved studies and reviews for other published, unpublished, or ongoing studies. For each included study, we performed a citation search in Web of Science to identify any later studies that may have cited it. Selection criteriaWe searched for randomised controlled trials comparing the efficacy of amphetamines (at any dose) for ADHD in adults aged 18 years and over against placebo or an active intervention. Data collection and analysisTwo review authors extracted data from each included study. We used the standardised mean difference (SMD) and the risk ratio (RR) to assess continuous and dichotomous outcomes, respectively. We conducted a stratified analysis to determine the influence of moderating variables. We assessed trials for risk of bias and drew a funnel plot to investigate the possibility of publication bias. We rated the quality of the evidence using the GRADE approach, which yielded high, moderate, low, or very low quality ratings based on evaluation of within-trial risk of bias, directness of evidence, heterogeneity of data; precision of effect estimates, and risk of publication bias.

Appraisal of clinical practice guidelines for the management of attention deficit hyperactivity disorder (ADHD) using the AGREE II Instrument: A systematic review

“…Currently, the total number of ADHD-related systematic review protocols registered in the PROSPERO database is 417, which comprises 337 ongoing reviews, 35 completed but not published including this review under study, 39 completed and published, one review is ongoing update, and two reviews that were discontinued [55]. Four Cochrane reviews on; (i) cognitive-behavioral interventions for attention deficit hyperactivity disorder (ADHD) in adults, (ii) methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents—assessment of adverse events in non-randomised studies; (iii) Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders; and (iv) Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults in addition to 9 protocols were published after the publication of the NICE CPG in 16 th of March 2018 [56–59]. Despite the utilization of systematic reviews in the included ADHD CPGs, an area for improvement remains regarding the utilization of high-quality systematic reviews like Cochrane reviews in these CPGs.…”

Effects of Neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review

“…The main treatment for ADHD continues to be pharmacological, with psychostimulant drugs (methylphenidate or amphetamines) being the most widely used [12]. However, the benefits are limited due to frequent adverse effects such as decreased appetite, headache, and insomnia, as well as poor adherence to treatment [5].…”

The neurochemistry of social reward during development: What have we learned from rodent models?

“…From a clinical perspective, despite there is evidence that the CPP paradigm has face validity for the rewarding properties of drugs (Castells et al 2018;Childs & de Wit, 2009Langleben et al 2014;Thewissen et al 2006) and food (Mogg et al 2012) in humans, further studies are needed to extend the translational potential of the sCPP procedure from rodents to humans.…”