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

ADHD is a very prevalent psychiatric disorder in adults, affecting about 2.5-6% of adults. It is frequently undiagnosed and untreated. Less is known about adult ADHD than childhood ADHD, and whether both conditions respond to treatment with the same types of treatment. This massive work surveys all clinical trial evidence to conclude that psychostimulants (methylphenidate- and dexamfetamine-based drugs) stand out as the only clear winner in treating Adult ADHD, although their use comes at the price of side effects.

This study could not endorse an improvement in the quality of life associated with treatment with these drugs. The meaning of this, and whether this is a technical issue in patient self-reports, could explain that puzzling finding. The non-stimulant drugs for Adult ADHD were unimpressive - guanfacine was not effective for treating core symptoms and atomoxetine caused more side effects than placebo, although it did help the core symptoms.

Non-drug interventions (e.g. psychological treatments, neurostimulation) were also unimpressive in helping the core symptoms and emotional dysregulation of ADHD. But it is important to note that, in clinical practice, we treat more than the core symptoms - ADHD is complicated by several psychiatric disorders such as anxiety and depression. It makes sense that these complications would not respond to psychostimulants as robustly. These findings reinforce the importance of treatment with psychostimulants for ADHD, with impact within 12 weeks. It does not rule out non-pharmacological interventions as being of value to the complications of this prevalent disorder.