Core ADHD Symptom Improvement With Atomoxetine Versus Methylphenidate A Direct Comparison Meta-Analysis

• Published in: Journal of attention disorders Vol. 15; no. 8; pp. 674 - 683
• Main Authors: Hazell, Philip L., Kohn, Michael R., Dickson, Ruth, Walton, Richard J., Granger, Renee E., van Wyk, Gregory W.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2011
• Subjects: Adolescent; Adolescents; Atomoxetine Hydrochloride; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Hyperactivity Disorder; Central Nervous System Stimulants - therapeutic use; Child; Children; Comparative Analysis; Drug Therapy; Female; Humans; Male; Meta Analysis; Methylphenidate - therapeutic use; Outcomes of Treatment; Patients; Propylamines - therapeutic use; Randomized Controlled Trials as Topic; Rating Scales; Symptoms (Individual Disorders); Treatment Outcome; meta-analysis; ADHD; methylphenidate; atomoxetine; child
• ISSN: 1087-0547; 1557-1246
• DOI: 10.1177/1087054710379737

Objective: Previous studies comparing atomoxetine and methylphenidate to treat ADHD symptoms have been equivocal. This noninferiority meta-analysis compared core ADHD symptom response between atomoxetine and methylphenidate in children and adolescents. Method: Selection criteria included randomized, controlled design; duration 6 weeks; and assessment of ADHD Rating Scale–IV–Parent Version: Investigator Administered and Scored (ADHDRS) scores. Six-week response rates, defined as ≥40% reduction in ADHDRS total score, were compared using a noninferiority margin of −15%. Results: Seven studies met inclusion criteria (N = 1,368). After 6 weeks, 53.6% (95% confidence interval [CI] 48.6%-58.4%) of atomoxetine-treated patients (n = 811) had responded compared with 54.4% (47.6%-61.1%) for methylphenidate (n = 557), with atomoxetine demonstrating noninferiority to methylphenidate (absolute difference −0.9%, 95% CI −9.2%-7.5%). Conclusion: After 6 weeks of treatment atomoxetine and methylphenidate had comparable efficacy in reducing core ADHD symptoms in children and adolescents.