On the CGI-I scale , the analysis revealed that MPH was more effective than ATX and GXR .
For any adverse events , RBX ( 89 % ) was the safest alternative .
Network meta- analysis offered a broader overview on the available treatments for ADHD , especially for safety issues , and contributes towards evidence gathering and clinical practice decisions .
The aim of this study is to gather evidence of head-to-head double-blind r and omized-controlled trials on the efficacy and safety of available treatments for attention deficit hyperactivity disorder ( ADHD ) in children and adolescents .
Effect of Extended-Release Dexmethylphenidate and Mixed Amphetamine Salts on Sleep: A Double-Blind, Randomized, Crossover Study in Youth with Attention-Deficit Hyperactivity Disorder
Objective We sought to determine the dose-response effects of extended-release ( ER ) dexmethylpheni date ( d-MPH ) and ER mixed amphetamine salts ( MAS ) on objective measures of sleep . Methods This was an 8-week , double-blind , placebo-controlled , r and omized , two period , crossover study of youth with attention-deficit hyperactivity disorder ( ADHD ) as confirmed by the Kiddie Schedule for Affective Disorders for School-Age Children – Present and Lifetime version ( K-SADS-PL ) . Children aged 10–17 years were recruited from clinical practice , colleague referrals , and flyers . Participants were r and omized to initially receive either d-MPH or MAS . During each 4-week drug period , children received three dose levels ( 10 , 20 , and 25/30 mg ) in ascending order , with placebo substituted for active medication in a r and omized fashion during 1 week of the study . After 4 weeks , participants were switched to the alternative medication for another 4 weeks of treatment . The main outcome measure was sleep duration as measured by actigraphy . Children , parents , and research ers were blinded to drug , dose , and placebo status . Results Sixty-five participants met the inclusion criteria and were enrolled in the study . Of these , 37 participants with sufficient sleep data for analysis were included .  Sleep schedule measures showed a significant effect for dose on sleep start time ( F(1,36 ) = 6.284 ; p < 0.05 ) , with a significantly later sleep start time when children were receiving 20- or 30-mg doses , compared with placebo ( p < 0.05 ) . A significant dose effect was found on actual sleep duration ( F(1,36 ) = 8.112 ; p < 0.05 ) , with significantly shorter actual sleep duration for subjects receiving 30 mg compared with those receiving placebo ( p < 0.05 ) . There were no significant differences on sleep duration or sleep schedule between the two stimulant medications . The trial is complete and closed to follow-up . Conclusions Higher stimulant doses were associated with reduced sleep duration and later sleep start times , regardless of medication class . Trial registration Clinical Trials.gov : NCT00393042
On the CGI-I scale , the analysis revealed that MPH was more effective than ATX and GXR .
For any adverse events , RBX ( 89 % ) was the safest alternative .
Network meta- analysis offered a broader overview on the available treatments for ADHD , especially for safety issues , and contributes towards evidence gathering and clinical practice decisions .
The aim of this study is to gather evidence of head-to-head double-blind r and omized-controlled trials on the efficacy and safety of available treatments for attention deficit hyperactivity disorder ( ADHD ) in children and adolescents .