Azapirones for Attention Deficit Hyperactivity Disorder: A Systematic Review

Matsui, Yoshihiko; Matsunaga, Satoru; Matsuda, Yuki; Kishi, Taro; Iwata, Nakao

doi:10.1055/s-0042-102457

Cited by 3 publications

(4 citation statements)

References 41 publications

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“…Available systematic reviews found only preliminary evidence (few studies with a low sample size and methodological issues) to support the efficacy of bupoprion,25 buspirone,26 aripiprazole,27 magnesium28 and reboxetine29 in adults with ADHD.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review

Crescenzo

Cortese

Adamo

et al. 2016

Evid Based Mental Health

111

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Attention-deficit/hyperactivity disorder (ADHD) is characterised by a persistent and impairing pattern of inattention and/or hyperactivity/impulsivity and it is one of the most common neuropsychiatric conditions. Evidence about interventions of adults with ADHD is growing rapidly and clinicians need a reliable summary of all the best available information in order to better inform their daily practice. We searched MEDLINE, PubMed, PsycINFO and Cochrane databases until 31 May 2016 for systematic reviews about pharmacological and non-pharmacological treatments in adults with ADHD and carried out a meta-review to address clinically relevant questions. We identified a total of 40 papers. Psychostimulants-such as methylphenidate, dexamphetamine, mixed amphetamine salts and lisdexamfetamine-and non-psychostimulants-such as atomoxetine-were the most studied agents. Overall, pharmacological treatments were significantly more efficacious than placebo (standardised mean difference (SMD) 0.45, 95% CI 0.37 to 0.52), albeit less well accepted (OR 1.18, 95% CI 1.02 to 1.36) and tolerated (OR 2.29, 95% CI 1.97 to 2.66). The effects of pharmacological treatment for individuals with co-occurring ADHD and substance use disorder are still uncertain. The evidence for the efficacy and effectiveness of non-pharmacological treatments of ADHD in adults, as well as the combination of pharmacological and non-pharmacological strategies, is only preliminary. In conclusion, while available evidence addressed mainly the efficacy and tolerability of psychostimulants and nonpsychostimulants for ADHD core symptoms in the short term, we still need further empirical support for the non-pharmacological and multimodal treatments. A comprehensive evidence-informed hierarchy of ADHD drugs based on their efficacy and tolerability is not yet available but it should be the next research priority in the field. INTRODUCTIONAttention-deficit/hyperactivity disorder (ADHD) is one of the most common neuropsychiatric conditions, 1 with a pooled worldwide prevalence estimated at about 5% in school-aged children and persistence of impairing symptoms in adulthood in up to 65% of cases.1 The pooled estimated prevalence of ADHD (as categorical diagnosis) in adults is around 2.5%.

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Section: Resultsmentioning

confidence: 99%

“…Only preliminary results on efficacy are available for bupropion,25 buspirone,26 aripiprazole,27 magnesium,28 and reboxetine29…”

Section: Discussionmentioning

confidence: 99%

Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review

Crescenzo

Cortese

Adamo

et al. 2016

Evid Based Mental Health

111

View full text Add to dashboard Cite

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“…A meta-analysis from 1999 also suggested similar findings for clonidine [127]. However, as for stimulants, meta-analyses and Cochrane review stated that the efficacy of some of the nonstimulants cannot be established due to short follow-up time, low quality, limited number of studies, sample sizes, and heterogeneity [128–130]. There is thus disagreement on how to interpret the literature also for nonstimulants.…”

Section: Resultsmentioning

confidence: 99%

“…There is, however, an interesting controversy on how solid the trial evidence on ADHD medication efficacy is. Several reviews on both children and adults, and for both stimulant and nonstimulant pharmacotherapy, conclude with caution as to conclusions on efficacy [123, 124, 128, 130, 135, 139, 157, 158].…”

Section: Discussionmentioning

confidence: 99%

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

Chaulagain,

Lyhmann,

Halmøy

et al. 2023

Eur. Psychiatr.

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Background There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD. Methods We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria. Results The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed. Conclusions Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.

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Buspirone

Robinson,

Rickels,

Farrington

2024

The American Psychiatric Association Publishing Textbook of Psychopharmacology

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Azapirones for Attention Deficit Hyperactivity Disorder: A Systematic Review

Abstract: It remains unclear whether buspirone use has benefit for ADHD patients and therefore further evidence is needed for better clinical use of buspirone in patients with ADHD.

Cited by 3 publications

References 41 publications

Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review

Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

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