Reacción a "Meta-analysis examines efficacy of ADHD treatments in adults"

This study systematically reviewed and meta-analysed over a hundred clinical trials of attention-deficit/hyperactivity disorder (ADHD) treatments, which collectively involved almost 15,000 adult participants (all over the age of 18 years; studies in children were excluded). The study identifies specific treatments for ADHD which were effective in reducing core symptoms of this complex and heterogeneous brain disorder.

Some treatments were found to be effective (in the combined ‘network meta-analysis’) on both clinician-reported and self-reported measures, whereas others were only effective on self-reported measures. However, even those treatments that were effective for core symptoms did not show significant benefits in ‘quality of life’ measures.

As David Coghill noted in his associated Lancet Psychiatry commentary article, it is extremely challenging for clinicians to know ‘how best to balance the merits of pharmacological and non-pharmacological approaches’ and that different types of clinical trials differ in ways that make them very difficult to compare directly (in such a meta-analysis).

So the key message for mental health clinicians and researchers is that some existing treatments are effective, but we could do much better in making them more effective, with fewer side effects. The ideal we are striving for in ongoing research is ‘precision psychiatry’ (as part of ‘precision medicine’) where treatment is tailored to the individual based not only on their symptoms but also biological ‘markers’. This requires much more research to understand the causes of ADHD and identify new approaches for novel therapies.