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 .
A controlled trial of extended-release guanfacine and psychostimulants for attention-deficit/hyperactivity disorder.
OBJECTIVE To examine efficacy , tolerability , and safety of guanfacine extended release ( GXR ; ≤4 mg/d ) adjunctive to a long-acting psychostimulant for the treatment of attention-deficit/hyperactivity disorder ( ADHD ) in children and adolescents 6 to 17 years of age with suboptimal , but partial , response to psychostimulant alone . METHOD In this multicenter , 9-week , double-blind , placebo-controlled , dose-optimization study , subjects ( N = 461 ) continued their stable dose of psychostimulant given in the morning and were r and omized to receive GXR in the morning ( GXR AM ) , GXR in the evening ( GXR PM ) , or placebo .  Efficacy measures included ADHD Rating Scale IV ( ADHD-RS-IV ) and Clinical Global Impressions of Severity of Illness ( CGI-S ) and Improvement ( CGI-I ) scales . Safety measures included adverse events ( AEs ) , vital signs , electrocardiograms , and laboratory evaluations . RESULTS At endpoint , GXR treatment groups showed significantly greater improvement from baseline ADHD-RS-IV total scores compared with placebo plus psychostimulant ( GXR AM , p = .002 ; GXR PM , p < .001 ) . Significant benefits of GXR treatment versus placebo plus psychostimulant were observed on the CGI-S ( GXR AM , p = .013 ; GXR PM , p < .001 ) and CGI-I ( GXR AM , p = .024 ; GXR PM , p = .003 ) . At endpoint , small mean decreases in pulse , systolic , and diastolic blood pressure were observed in GXR treatment groups versus placebo plus psychostimulant . No new safety signals emerged following administration of GXR with psychostimulants versus psychostimulants alone . Most AEs were mild to moderate in severity . CONCLUSIONS Morning or evening GXR administered adjunctively to a psychostimulant showed significantly greater improvement over placebo plus psychostimulant in ADHD symptoms and generated no new safety signals . Clinical trial registration information-Efficacy and Safety of SPD503 in Combination With Psychostimulants ; http://www . clinical trials.gov ; NCT00734578
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 .