Systematic Review and Meta-Analysis: Effects of Pharmacological Treatment for Attention-Deficit/Hyperactivity Disorder on Quality of Life - 26/02/25
, Nadia J. Perrott, MSc a, ∗, Lucia Marzulli, PhD c, Valeria Parlatini, MD, PhD a, d, e, David Coghill, MD, PhD f, g, Samuele Cortese, MD, PhD a, c, e, hAbstract |
Objective |
We conducted a systematic review and meta-analysis to quantify the effect of attention-deficit/hyperactivity disorder (ADHD) medication on quality of life (QoL), and to understand whether this effect differs between stimulants and nonstimulants.
Method |
From the dataset of a published network meta-analysis (Cortese et al., 20181), updated on 27th February 2023 (med-adhd.org/), we identified randomized controlled trials (RCTs) of ADHD medications for individuals aged 6 years or more with a diagnosis of ADHD based on the DSM (from third to fifth editions) or the International Classification of Diseases (ICD; ninth or tenth revision), reporting data on QoL (measured with a validated scale). The risk of bias for each RCTs was assessed using the Cochrane Risk of Bias tool 2. Multilevel meta-analytic models were conducted with R 4.3.1.
Results |
We included 17 RCTs (5,388 participants in total; 56% randomized to active medication) in the meta-analyses. We found that amphetamines (Hedge's g = 0.51, 95% CI = 0.08, 0.94), methylphenidate (0.38; 0.23, 0.54), and atomoxetine (0.30; 0.19, 0.40) were significantly more efficacious than placebo in improving QoL in people with ADHD, with moderate effect size. For atomoxetine, these effects were not moderated by the length of intervention, and did not differ between children/adolescents and adults.
Conclusion |
In addition to being efficacious in reducing ADHD core symptom severity, both stimulant and nonstimulant medications are efficacious in improving QoL in people with ADHD, albeit with lower effect sizes. Future research should explore whether, and to what degree, combining pharmacological and nonpharmacological interventions is likely to further improve QoL in people with ADHD.
Plain language summary |
From a prior dataset of a network meta-analysis, 17 randomized controlled trials (RCTs) were included in a meta-analysis to investigate if attention-deficit/hyperactivity disorder (ADHD) medication improves quality of life (QoL) in people with ADHD. The analysis showed that medications such as amphetamines, methylphenidate, and atomoxetine improved QoL compared to placebo, with moderate effect sizes. This study underscores the importance of ADHD medications, both stimulants and nonstimulants, not only in alleviating core ADHD symptoms but also in enhancing overall QoL for individuals with ADHD.
Study preregistration information |
Effects of pharmacological treatment for ADHD on quality of life: a systematic review and meta-analysis; osf.io/; qvgps.
Le texte complet de cet article est disponible en PDF.Key words : ADHD, stimulants, nonstimulants, quality of life, RCT
Plan
| The authors have reported no funding for this work. |
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| This work has been prospectively registered: qvgps/. |
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| Disclosure: Dr. Bellato has declared an honorarium as Joint Editor of JCPP Advances. Prof. Coghill has received honoraria or conference support from Novartis, Medice, Takeda, and Servier and royalties from Cambridge University Press and Oxford University Press. Prof. Cortese has declared honoraria and reimbursement for travel and accommodation expenses for lectures from the following non-profit associations: Association for Child and Adolescent Central Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association of Pharmacology (BAP), Medice, and Healthcare Convention for educational activity on ADHD. He has served on the advisory board of the Association for Child and Adolescent Mental Health and the British Association for Psychopharmacology. Drs. Marzulli and Parlatini and Ms. Perrott have reported no biomedical financial interests or potential conflicts of interest. |
Vol 64 - N° 3
P. 346-361 - mars 2025 Retour au numéro
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