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Review
. 2022 Feb:230:107940.
doi: 10.1016/j.pharmthera.2021.107940. Epub 2021 Jun 23.

Evidence-based pharmacological treatment options for ADHD in children and adolescents

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Free article
Review

Evidence-based pharmacological treatment options for ADHD in children and adolescents

Konstantin Mechler et al. Pharmacol Ther. 2022 Feb.
Free article

Abstract

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, causing functional impairment. Its prevalence lies at approximately 5% in children and adolescents and at approximately 2.5% in adults. The disorder follows a multifactorial etiology and shows a high heritability. Patients show a high interindividual and intraindividual variability of symptoms, with executive deficits in several cognitive domains. Overall, ADHD is associated with high rates of psychiatric comorbidities, and insufficient treatment is linked to adverse long-term outcomes. Current clinical guidelines recommend an individualized multimodal treatment approach including psychoeducation, pharmacological interventions, and non-pharmacological interventions. Available medications include stimulants (methylphenidate, amphetamines) and non-stimulants (atomoxetine, guanfacine, clonidine). While available pharmacological treatment options for ADHD show relatively large effect sizes (in short-term trials) and overall good tolerability, there is still a need for improvement of current pharmacotherapeutic strategies and for the development of novel medications. This review summarizes available pharmacological treatment options for ADHD in children and adolescents, identifies current issues in research and evidence gaps, and provides an overview of ongoing efforts to develop new medications for the treatment of ADHD in children and adolescents by means of a systematic cross-sectional analysis of the clinical trials registry www.clinicaltrials.gov.

Keywords: Amphetamines; Atomoxetine; Attention-deficit hyperactivity disorder; Clonidine; Guanfacine; Methylphenidate; Psychopharmacology.

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Conflict of interest statement

Declaration of Competing Interest Konstantin Mechler was involved as investigator in clinical trials by Shire, Otsuka, Sunovion, Servier, Lundbeck, Takeda, Nuvelution, Gedeon Richter, and Emalex. Tobias Banaschewski served in an advisory or consultancy role for Lundbeck, Medice, Neurim Pharmaceuticals, Oberberg GmbH, Takeda, and Infectopharm. He received conference support or speaker's fees by Lilly, Medice, and Takeda. He received royalties from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press. Sarah Hohmann was involved as investigator in a clinical trial by Servier. Alexander Häge received conference support, speaker's fees and/or served in an advisory role for Shire/Takeda and Lily. He was involved as investigator in clinical trials by Shire, Takeda, Janssen-Cilag, Otsuka, Sunovion, Servier, Lundbeck, Nuvelution, Gedeon Richter, and Emalex.

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