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Review: pharmacological interventions are more effective than non-pharmacological for attention deficit hyperactivity disorder

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 QUESTIONS: In patients with attention deficit hyperactivity disorder (ADHD), what are the short term and long term effectiveness and safety of pharmacological and non-pharmacological interventions? Are combined interventions more effective than single interventions?

Data sources

Studies were identified by searching Medline (1966–97), CINAHL (1982–97), PsycINFO (1984–97), EMBASE/Excerpta Medica (1984–97), and the Cochrane Library and by reviewing references of relevant studies, web sites of organisations funding research on ADHD, and files of research team members and partner organisations.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) of treatment for ADHD published in peer reviewed journals. Specific interventions considered were drug compared with drug (methylphenidate, dextroamphetamine, and pemoline), placebo compared with tricyclic antidepressant, drug compared with non-drug, combination treatments, long term treatments (≥12 wks), treatments for ADHD in adults, and adverse effects.

Data extraction

Data were extracted by 2 independent reviewers on 41 study elements, including methodological quality, study design attributes, funding, patient characteristics, sampling issues, diagnosis, …

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  • Source of funding: US Agency for Healthcare Research and Quality.

  • For correspondence: Dr A R Jadad, McMaster University, Health Sciences Centre, Room 3H7, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada.