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ADHD: methylphenidate should be first line drug treatment in children, review confirms

BMJ 2018; 362 doi: (Published 07 August 2018) Cite this as: BMJ 2018;362:k3430
  1. Gareth Iacobucci
  1. The BMJ

Methylphenidate is the most effective and safest short term drug treatment for children with attention-deficit hyperactivity disorder (ADHD), while amphetamines are most effective in adults, a major analysis has found.1

The findings should help clinicians navigate the current inconsistency in guidelines. While the findings match recommendations on first line drugs from the UK’s National Institute for Health and Care Excellence, other protocols in Europe recommend psychostimulants as first line treatment without any distinction between methylphenidate and amphetamines.

The network meta-analysis and systematic review, published in the Lancet Psychiatry,1 compared the effectiveness and side effects of seven medicines with each other or with placebo over 12 weeks of treatment. It examined amphetamines (including lisdexamfetamine), atomoxetine, bupropion, …

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