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 .
A comparison of morning-only and morning/late afternoon Adderall to morning-only, twice-daily, and three times-daily methylphenidate in children with attention-deficit/hyperactivity disorder.
OBJECTIVE 1 ) To compare st and ard twice-daily methylpheni date ( MPH ) dosing with a single morning dose of MPH and of Adderall during a typical school-day time period , and 2 ) to conduct a dose-response study of the effects of a late-afternoon ( 3:30 PM ) dose of MPH and Adderall on evening behavior and side effects . DESIGN Within-subject , placebo-controlled , crossover design . SETTING Intensive summer treatment program with a comprehensive behavioral approach . STUDY PARTICIPANTS Twenty-one children with attention-deficit/hyperactivity disorder ( 19 boys and 2 girls ) , between the ages of 6 and 12 years . INTERVENTIONS Children received , in r and om order with daily crossovers , each of the following conditions : 1 ) placebo , 2 ) 0.3 mg/kg of MPH received 3 times , 3 ) 0.3 mg/kg of MPH received twice ( 7:30 AM and 11:30 AM ) with 0.15 mg/kg received at 3:30 PM , 4 ) 0.3 mg/kg of MPH received once in the morning only , 5 ) 0.3 mg/kg of Adderall received at 7:30 AM and at 3:30 PM , 6 ) 0.3 mg/kg of Adderall once in the morning with 0.15 mg/kg received at 3:30 PM , 7 ) 0.3 mg/kg of Adderall received in the morning only . OUTCOME MEASURES Daily rates of behaviors in social and academic setting s , and st and ardized ratings from counselors and teachers , were assessed for the hours between 8:00 AM and 3:30 PM ( a typical school-day ) . Relative sizes of the medication effects were compared hourly between first daily ingestion ( 7:30 AM ) and 4:45 PM to assess the time course of the 2 drugs . Effects of the 3:30 PM doses on functioning in the evenings at home were evaluated using parent ratings of behavioral and side effects . RESULTS A single morning dose of Adderall produced equivalent behavioral effects to those of MPH received twice-daily and behavioral effects of that single morning dose lasted throughout the school-day period . One morning dose of MPH was less effective than either 2 daily doses of MPH or 1 dose of Adderall , and seemed to wear off in the early to mid-afternoon . For some children a single morning dose of MPH maintained their behavior for an entire school day in the context of the summer treatment program . On parent ratings of evening behavior , 0.3 mg/kg of MPH at 3:30 PM was superior to 0.15 mg/kg at 3:30 PM , but there was no difference between the 2 doses of Adderall . Compared with placebo at 3:30 PM , only the 0.3 mg/kg dose of MPH caused significant improvement in parent ratings . In placebo versus Adderall comparisons , all doses , even the condition that consisted of Adderall in the morning and placebo at 3:30 PM , produced a significant change in evening behavior . CONCLUSIONS The results show that , at least in the context of an intensive behavioral intervention , a single morning dose of Adderall had behavioral effects throughout an entire school day period that were equivalent to st and ard twice-daily MPH dosing . These results indicate that Adderall may be used as a long-acting stimulant for children for whom midday dosing is a problem . Further study including dose-response comparisons , effects in regular school setting s , and direct comparisons with comparable doses of MPH and d-amphetamine will help to clarify the time course and relative advantages of Adderall
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 .