Analysis of ADHD Drugs: Use Methylphenidate in Kids, Amphetamines in Adults

By Joe Elia

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

A meta-analysis of the drugs used to treat attention-deficit/hyperactivity disorder in the short term finds the best choices to be methylphenidate in children and adolescents, and amphetamines in adults, according to a Lancet Psychiatry report.

Researchers examined efficacy and tolerability data from published and unpublished double-blind, randomized, controlled trials. The 133 trials included some 14,000 children and 10,000 adults. Other drugs evaluated in the "network meta-analysis," which allows indirect comparisons of drugs not directly tested head-to-head, included atomoxetine, bupropion, clonidine, guanfacine, and modafinil.

Overall, results favored using methylphenidate in children and adolescents, and amphetamines in adults as first-line, short-term (12 weeks or under) treatment.

Asked to comment, Dr. Barbara Geller of NEJM Journal Watch Psychiatry wrote: "The two most effective drugs (methylphenidate for children, amphetamine for adults) should be prescribed first because they have good safety records after decades on the market."