At the class level , behavioural therapy ( alone or in combination with stimulants ) , stimulants , and non-stimulant seemed significantly more efficacious than placebo .
Behavioural therapy in combination with stimulants seemed superior to stimulants or non-stimulants .
Stimulants seemed superior to behavioural therapy , cognitive training and non-stimulants .
Behavioural therapy , stimulants and their combination showed the best profile of acceptability .
Stimulants and non-stimulants seemed well tolerated .
Among medications , methylpheni date , amphetamine , atomoxetine , guanfacine and clonidine seemed significantly more efficacious than placebo .
Methylpheni date and amphetamine seemed more efficacious than atomoxetine and guanfacine .
Methylpheni date and clonidine seemed better accepted than placebo and atomoxetine .
Most of the efficacious pharmacological treatments were associated with harms ( anorexia , weight loss and insomnia ) , but an increased risk of serious adverse events was not observed .
There is lack of evidence for cognitive training , neurofeedback , antidepressants , antipsychotics , dietary therapy , fatty acids , and other complementary and alternative medicine .
Clinical differences may exist between the pharmacological and non-pharmacological treatment used for the management of ADHD .
BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) is one of the most commonly diagnosed psychiatric disorders in childhood .
A wide variety of treatments have been used for the management of ADHD .
We aim ed to compare the efficacy and safety of pharmacological , psychological and complementary and alternative medicine interventions for the treatment of ADHD in children and adolescents .
Treatment of ADHD in children with tics: A randomized controlled trial
Background The treatment of children with attention deficit hyperactivity disorder ( ADHD ) and Tourette syndrome ( TS ) has been problematic because methylpheni date (MPH)—the most commonly used drug to treat ADHD — has been reported to worsen tics and because clonidine (CLON)—the most commonly prescribed alternative — has unproven efficacy . Methods The authors conducted a multicenter , r and omized , double-blind clinical trial in which 136 children with ADHD and a chronic tic disorder were r and omly administered CLON alone , MPH alone , combined CLON + MPH , or placebo ( 2 × 2 factorial design ) . Each subject participated for 16 weeks ( weeks 1–4 CLON/placebo dose titration , weeks 5–8 added MPH/placebo dose titration , weeks 9–16 maintenance therapy ) . Results Thirty-seven children were administered MPH alone , 34 were administered CLON alone , 33 were administered CLON + MPH , and 32 were administered placebo . For our primary outcome measure of ADHD ( Conners Abbreviated Symptom Question naire – Teacher ) , significant improvement occurred for subjects assigned to CLON ( p < 0.002 ) and those assigned to MPH ( p < 0.003 ) . Compared with placebo , the greatest benefit occurred with combined CLON + MPH ( p < 0.0001 ) . CLON appeared to be most helpful for impulsivity and hyperactivity ; MPH appeared to be most helpful for inattention . The proportion of individual subjects reporting a worsening of tics as an adverse effect was no higher in those treated with MPH ( 20 % ) than those being administered CLON alone ( 26 % ) or placebo ( 22 % ) . Compared with placebo , measured tic severity lessened in all active treatment groups in the following order : CLON + MPH , CLON alone , MPH alone . Sedation was common with CLON treatment ( 28 % reported moderate or severe sedation ) , but otherwise the drugs were tolerated well , including absence of any evident cardiac toxicity . Conclusions Methylpheni date and clonidine ( particularly in combination ) are effective for ADHD in children with comorbid tics . Prior recommendations to avoid methylpheni date in these children because of concerns of worsening tics are unsupported by this trial
At the class level , behavioural therapy ( alone or in combination with stimulants ) , stimulants , and non-stimulant seemed significantly more efficacious than placebo .
Behavioural therapy in combination with stimulants seemed superior to stimulants or non-stimulants .
Stimulants seemed superior to behavioural therapy , cognitive training and non-stimulants .
Behavioural therapy , stimulants and their combination showed the best profile of acceptability .
Stimulants and non-stimulants seemed well tolerated .
Among medications , methylpheni date , amphetamine , atomoxetine , guanfacine and clonidine seemed significantly more efficacious than placebo .
Methylpheni date and amphetamine seemed more efficacious than atomoxetine and guanfacine .
Methylpheni date and clonidine seemed better accepted than placebo and atomoxetine .
Most of the efficacious pharmacological treatments were associated with harms ( anorexia , weight loss and insomnia ) , but an increased risk of serious adverse events was not observed .
There is lack of evidence for cognitive training , neurofeedback , antidepressants , antipsychotics , dietary therapy , fatty acids , and other complementary and alternative medicine .
Clinical differences may exist between the pharmacological and non-pharmacological treatment used for the management of ADHD .
BACKGROUND Attention deficit hyperactivity disorder ( ADHD ) is one of the most commonly diagnosed psychiatric disorders in childhood .
A wide variety of treatments have been used for the management of ADHD .
We aim ed to compare the efficacy and safety of pharmacological , psychological and complementary and alternative medicine interventions for the treatment of ADHD in children and adolescents .