By Andreia Conegero, Ph.D., Federal University of Paraná
In short, what is the study about?
This study is the first safety network of five drugs used in the treatment of Attention Deficit Hyperactivity Disorder in adult patients without comorbidities, it includes: (1) Atomoxetine (noradrenergic agent), (2) Mixed amphetamine extended release (psychostimulant), (3) Methylphenidate release by osmotic system (OROS) (psychostimulant), (4) Bupropion (antidepressant), (5) Bavisant (antihistamine).
Thus, the objective of this study was to gather evidence of safety about the therapeutic options available for ADHD to assist clinical decision making to choose the most appropriate treatment for this age group.
What would be the most important take-home messages from the study?
The outcome of this study, based on statistical methods, refers to medication interventions, one of the options treatment for ADHD. The evidence points to the probabilities of each evaluated drug to cause adverse events such as anorexia, decreased appetite, insomnia, somnolence, and decreased libido. As well as, what the therapeutic option proved to be safer for these outcomes. These data highlight the importance of the search for a well-founded information on the safety, efficacy and tolerability aspects of each therapeutic option, as well as a detailed clinical evaluation of the patient, so that it is possible to evaluate what is the best treatment among the alternatives according to the best risk-benefits and clinical condition of the patient. In addition, the correct diagnosis is critical in this context, so that the individual does not receive an unnecessary treatment.
Although not addressed in the study, ADHD can also be treated through social, psychological and behavioral interventions, either alone or in combination with medication, which may help in improving the symptoms and performance of the patient with ADHD in the daily activities.
How are these findings important in practice?
Evidence generated by systematic review with meta-analysis is considered the gold standard of health care and is essential to define adequate therapeutic management. Thus the results found can be used as a tool for clinical decision making and assistance in the elaboration of protocols and guidelines and in the follow-up of patients diagnosed with ADHD.
What other studies can be recommended to further an understanding/application of the findings?
Clinical trials with larger, methodologically reliable sample populations are recommended to assess the safety, efficacy, and tolerability of ADHD drug therapy, so that more robust evidence can be generated through systematic reviews of interventions.