Safety of Treatments for ADHD in Adults: Pairwise and Network Meta-Analyses

Apr 4, 2017Journal of attention disorders

Safety of Different ADHD Treatments in Adults Compared Directly and Across Studies

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Abstract

Analysis of 10 trials involving 3006 adult patients revealed significant differences in the safety profile of ADHD medications.

Atomoxetine was associated with a lower likelihood of decreased appetite compared to placebo (odds ratio [OR] = 0.15).
Extended-release mixed amphetamine salts also showed a significant reduction in decreased appetite compared to placebo (OR = 0.06).
Insomnia was less likely with atomoxetine compared to placebo (OR = 0.48) and with extended-release mixed amphetamine salts (OR = 0.23).
Patients taking atomoxetine experienced less sleepiness compared to those on methylphenidate OROS (OR = 0.24).
Decreased libido was less common in patients treated with atomoxetine compared to placebo (OR = 0.28).

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OBJECTIVE: The aim of the study was to analyze evidence comparing the profile of drugs used to treat ADHD in adult patients.

METHOD: Systematic searches were conducted in electronic databases. Randomized, double-blind, parallel controlled trials that evaluated the safety of drugs in ADHD were included. The statistical analyses were conducted by pairwise meta-analyses and mixed treatment comparison (MTC).

RESULTS: Ten ( n = 3006) trials were included in the analyses. We observed statistical differences for the following outcomes: decreased appetite between atomoxetine and placebo (odds ratio [OR] = 0.15, 95% credibility interval [CrI] = [0.05, 0.38]) and extended-release mixed amphetamine salts and placebo (OR = 0.06, 95% CrI = [0.00, 0.51]); insomnia between atomoxetine and placebo (OR = 0.48, 95% CrI = [0.27, 0.88]) and extended-release mixed amphetamine salts and placebo (OR = 0.23, 95% CrI = [0.06, 0.76]); sleepiness between atomoxetine and methylphenidate OROS (OR = 0.24, 95% CrI = [0.06, 0.97]); and decreased libido between atomoxetine and placebo (OR = 0.28, 95% CrI = [0.08, 0.90]).

CONCLUSION: It was possible to generate evidence about the safety profile of different ADHD drugs.

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Safety of Treatments for ADHD in Adults: Pairwise and Network Meta-Analyses

Abstract

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