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 .
Side effects of methylphenidate and dexamphetamine in children with attention deficit hyperactivity disorder: a double-blind, crossover trial.
OBJECTIVE To compare the side effect profiles of methylpheni date ( MPH ) and dexamphetamine ( DEX ) in children with attention deficit hyperactivity disorder ( ADHD ) , as well as to determine which symptoms are genuine adverse effects of stimulant medication , as opposed to aspects of the child 's underlying behavioral phenotype . DESIGN Double-blind , crossover study . SETTING Pediatric teaching hospital ambulatory behavior clinic . SUBJECTS A total of 125 children with ADHD with a mean age of 104.8 months . INTERVENTIONS Subjects received DEX ( 0.15 mg/kg/dose ) and MPH ( 0.3 mg/kg/dose ) twice a day for 2 weeks each in a r and omized order . OUTCOME MEASURES The Barkley Side Effects Rating Scale ( 17 symptoms ; 0 = absent , severity rated from 1 to 9 ) was completed by parents at baseline and at the completion of each trial fortnight . RESULTS Subjects ' parents reported a significantly greater mean number ( 8.19 ) and mean severity ( 4.08 ) of " side effects " before commencing the trial than during the MPH period ( number 7.19 ; severity 3.24 ) , but not the DEX period ( number 7.64 , severity 3.73 ) . The mean severity ( but not mean number ) was greater on DEX than on MPH . DEX caused more severe insomnia and appetite suppression compared with the baseline rating . Appetite suppression was the only item rated more severe on MPH than at baseline . Six side effects were significantly more severe on DEX than MPH : insomnia , irritability , proneness to crying , anxiousness , sadness/unhappiness , and nightmares . None were more severe on MPH than DEX . Overall , both MPH and DEX were well tolerated by most subjects , with only four subjects discontinuing the trial period because of severe adverse effects ( 2 -1.6%- on each stimulant ) . CONCLUSIONS Many symptoms commonly attributed to stimulant medication are actually preexisting characteristics of children with ADHD and improve with stimulant treatment . At the doses investigated , both DEX and MPH caused appetite suppression , and DEX caused insomnia . Negative emotional symptoms were more severe on DEX than MPH
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 .