Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder

Coghill, David; Banaschewski, Tobias; Soutullo, César; Cottingham, Matthew G.; Zuddas, Alessandro

doi:10.1007/s00787-017-0986-y

Cited by 86 publications

(72 citation statements)

References 99 publications

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“…Future studies should extend our data to larger samples of low-and high-dose BZD/Z-drug users through a multicenter design. Since pharmacological treatment may help reduce QoL impairment in ADHD patients [51], longitudinal studies should explore whether appropriate BZD/Z-drug detoxification might improve QoL measures and whether the most appropriate detoxification protocol differ in ADHD+ versus ADHD− populations.…”

Section: Discussionmentioning

confidence: 99%

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

et al. 2020

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Background: Problematic high-dose benzodiazepine (BZD) and related Z-drug use for a long period is a substance use disorder previously found to be associated with adult attention-deficit/hyperactivity disorder (ADHD) and worse quality of life (QoL). Whether adult ADHD impacts QoL in high-dose BZD/Z-drug users has not been explored. Aim: The aim of the study was to explore the impact of adult ADHD on QoL in high-dose BZD and related Z-drug users. Methods: We recruited 393 patients (205 men and 188 women) consecutively admitted to the

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Section: Discussionmentioning

confidence: 99%

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

et al. 2020

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“…62 It is critical to treat ADHD early and effectively to minimize harm and increase a patient's quality of life. 42,44,63 It is also important to note that pharmacotherapy is just one component of an ADHD treatment plan. For instance, in preschool-aged children with ADHD, the recommended first line of treatment is behavioral therapy and methylphenidate should be prescribed only if the behavioral interventions do not provide sufficient improvement and moderate-to-severe disturbances continue to affect the child's function.…”

Section: Treatment Reduces the Risk Of Morbidity And Mortality And Inmentioning

confidence: 99%

Individualization of attention-deficit/hyperactivity disorder treatment: pharmacotherapy considerations by age and co-occurring conditions

et al. 2020

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Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood and can persist into adolescence and adulthood. Impairments associated with ADHD can impact quality of life, social interactions, and increase the risk of morbidity and mortality; however, for many patients, effective treatment can lessen these effects. Pharmacotherapy with stimulants or nonstimulants is recommended in conjunction with psychosocial therapy for most patients. Determining the optimal pharmacotherapy can be complex, and the clinician needs to consider many factors such as the patient’s age, comorbidities, and lifestyle. Furthermore, the needs of the patient with ADHD will change over time, with specific challenges to consider at each stage of life. A variety of Food and Drug Administration (FDA)-approved stimulant and nonstimulant formulations are available with different modes of delivery and durations of effect. This armamentarium of ADHD medications can be used to individualize ADHD treatment for each patient’s needs. This article combines current information from the literature and the first-hand experience of the authors to provide guidance on ADHD treatment options for patients of different ages and for some of the more common comorbidities.

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“…There is evidence that psychostimulants including methylphenidate have a moderate-to-large short-term (i.e., up to 16 weeks) effect on the management of oppositional behavior, conduct problems, and aggression in children and adolescents with ADHD with or without comorbid oppositional-deviant disorder (ODD) or conduct disorder (Pringsheim et al, 2015). Furthermore, systematic reviews concluded that there may be a short-term positive effect of ADHD medication on QoL in children and adolescents (Coghill, 2010;Coghill et al, 2017). However, the effect sizes are smaller than seen for ADHD symptoms and almost exclusively based on studies examining atomoxetine.…”

Section: Introductionmentioning

confidence: 99%

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

Matthijssen

Dietrich

Bierens

et al. 2020

Journal of Child and Adolescent Psychopharmacology

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Objectives: To study the effects of discontinuation of long-term methylphenidate use on secondary outcome measures of strengths and difficulties, quality of life (QoL), and parenting stress. Methods: Ninety-four children and adolescents aged 8 to 18 years who had used methylphenidate for over 2 years were randomly assigned to double-blind continuation of treatment for 7 weeks (36 or 54 mg extended release methylphenidate) or to gradual withdrawal over 3 to 4 weeks placebo. We used mixed models for repeated measures to investigate effects on parent, teacher, and child ratings of hyperactivity/inattention and comorbid symptoms with the Strengths and Difficulties Questionnaire (SDQ), investigator-and teacher-rated oppositional symptoms (Conners Teacher Rating Scale-Revised: short form [CTRS-R:S]), and parent-rated aggression with the Retrospective Modified Overt Aggression Scale. QoL was assessed with the Revised Questionnaire for Children and Adolescents to record health-related quality of life and parenting stress with the Nijmegen Parental Stress Index. Results: Hyperactivity/inattention scores from the parent-and teacher-rated SDQ (difference in mean change over time of respectively:-1.1 [95% confidence interval, CI,-2.0 to-0.3]; p = 0.01;-2.9 [95% CI-2.9 to-0.7; p = 0.01]) and oppositional scores of the teacher-rated CTRS-R:S (difference in mean change-1.9 95% CI [-3.1 to-0.6; p < 0.01]) deteriorated to a significantly larger extent in the discontinuation group than in the continuation group. We did not find effects on other symptom domains, aggression, QoL, and parenting stress after discontinuation of methylphenidate. Conclusion: Our study suggests beneficial effects of long-term methylphenidate use beyond 2 years for oppositional behaviors in the school environment. Similarly, beneficial effects were found on hyperactivity-inattention symptoms as rated by parent and teacher scales, confirming our primary study on investigator ratings of attention-deficit/hyperactivity disorder. However, discontinuation of methylphenidate did not appear to have impact on other comorbid problems or aspects of the child's or parental functioning.

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Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder

Cited by 86 publications

References 99 publications

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

Individualization of attention-deficit/hyperactivity disorder treatment: pharmacotherapy considerations by age and co-occurring conditions

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

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