This systematic review and meta-analysis synthesize results from numerous studies to assess the long-term effects of ADHD medications, focusing on stimulants such as methylphenidate and amphetamine, and nonstimulant treatments. The review gathers data from Randomized Controlled Trials (RCTs) and observational studies with at least five years of follow-up, encompassing a substantial sample size from several international databases. The analysis confirms that pharmacotherapy for ADHD, which includes stimulants and non-stimulants, contributes to improved academic performance, social functioning, and reduces the risk of substance abuse and criminal behavior. While stimulants are highlighted for their effectiveness in symptom reduction and positive impact on social and academic outcomes, non-stimulants also demonstrate benefits, albeit with less consistency across studies. In addition, the research examines the comparative effectiveness and tolerability of these medications, noting that methylphenidate and amphetamine are generally the most effective, while clonidine, atomoxetine, and guanfacine are less so. Adverse effects, which vary by drug type, are recognized as important considerations, particularly in the context of comorbid tic disorders. The overall safety profile of these medications is considered acceptable, although stimulants are associated with a higher incidence of adverse events.