Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials

© 2015 Maneeton et al. Background: The efficacy of dexmethylphenidate (d-MPH) has been proven in the treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Objective: The aim of this systematic review is to determine the efficacy, acceptability, and tolerability...

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Main Authors: Narong Maneeton, Benchalak Maneeton, Pakapan Woottiluk, Sirijit Suttajit, Surinporn Likhitsathian, Chawanun Charnsil, Manit Srisurapanont
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/44062
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spelling th-cmuir.6653943832-440622018-04-25T07:45:12Z Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials Narong Maneeton Benchalak Maneeton Pakapan Woottiluk Sirijit Suttajit Surinporn Likhitsathian Chawanun Charnsil Manit Srisurapanont Agricultural and Biological Sciences © 2015 Maneeton et al. Background: The efficacy of dexmethylphenidate (d-MPH) has been proven in the treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Objective: The aim of this systematic review is to determine the efficacy, acceptability, and tolerability of d-MPH in child and adolescent ADHD. Methods: The searches of SCOPUS, MEDLINE, CINAHL, and Cochrane Controlled Trials Register were performed in February 2015. All randomized controlled trials of d-MPH versus placebo that were performed in children and adolescents with ADHD up to 18 years of age were included in the study. The efficacy was measured by using the pooled mean-endpoint or mean-changed scores of ADHD rating scales and the response rate. Acceptability and tolerability were measured by using the pooled rates of overall discontinuation and discontinuation due to adverse events, respectively. Results: A total of 1,124 children and adolescents diagnosed as having ADHD were included in this review. In a laboratory school setting, the pooled mean-change and mean-endpoint scores in the d-MPH-treated group were significantly greater than those of the placebo-treated group with standardized mean difference (95% confidence interval [CI]) of −1.20 (−1.73, −0.67), I 2 =95%. Additionally, the pooled mean-changed scores of the ADHD rating scales for teachers and parents in the d-MPH-treated group were significantly greater than that of the placebo-treated group with weighted mean difference (95% CI) of −13.01 (−15.97, −10.05), I 2 =0% and (95% CI) of −12.99 (−15.57, −10.42), I 2 =0%, respectively. The pooled response rate in the d-MPH-treated groups had a significance higher than that of the placebo-treated group. The rates of pooled overall discontinuation and discontinuation due to adverse events between the two groups were not significantly different. Conclusion: Based on the findings in this review, it can be concluded that d-MPH medication is efficacious and tolerable in child and adolescent ADHD. However, the acceptability of d-MPH is no greater than that of the placebo. Further systematic studies may confirm these findings. 2018-01-24T04:37:38Z 2018-01-24T04:37:38Z 2015-11-25 Journal 11782021 11766328 2-s2.0-84948995338 10.2147/NDT.S91765 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84948995338&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/44062
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Agricultural and Biological Sciences
spellingShingle Agricultural and Biological Sciences
Narong Maneeton
Benchalak Maneeton
Pakapan Woottiluk
Sirijit Suttajit
Surinporn Likhitsathian
Chawanun Charnsil
Manit Srisurapanont
Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
description © 2015 Maneeton et al. Background: The efficacy of dexmethylphenidate (d-MPH) has been proven in the treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Objective: The aim of this systematic review is to determine the efficacy, acceptability, and tolerability of d-MPH in child and adolescent ADHD. Methods: The searches of SCOPUS, MEDLINE, CINAHL, and Cochrane Controlled Trials Register were performed in February 2015. All randomized controlled trials of d-MPH versus placebo that were performed in children and adolescents with ADHD up to 18 years of age were included in the study. The efficacy was measured by using the pooled mean-endpoint or mean-changed scores of ADHD rating scales and the response rate. Acceptability and tolerability were measured by using the pooled rates of overall discontinuation and discontinuation due to adverse events, respectively. Results: A total of 1,124 children and adolescents diagnosed as having ADHD were included in this review. In a laboratory school setting, the pooled mean-change and mean-endpoint scores in the d-MPH-treated group were significantly greater than those of the placebo-treated group with standardized mean difference (95% confidence interval [CI]) of −1.20 (−1.73, −0.67), I 2 =95%. Additionally, the pooled mean-changed scores of the ADHD rating scales for teachers and parents in the d-MPH-treated group were significantly greater than that of the placebo-treated group with weighted mean difference (95% CI) of −13.01 (−15.97, −10.05), I 2 =0% and (95% CI) of −12.99 (−15.57, −10.42), I 2 =0%, respectively. The pooled response rate in the d-MPH-treated groups had a significance higher than that of the placebo-treated group. The rates of pooled overall discontinuation and discontinuation due to adverse events between the two groups were not significantly different. Conclusion: Based on the findings in this review, it can be concluded that d-MPH medication is efficacious and tolerable in child and adolescent ADHD. However, the acceptability of d-MPH is no greater than that of the placebo. Further systematic studies may confirm these findings.
format Journal
author Narong Maneeton
Benchalak Maneeton
Pakapan Woottiluk
Sirijit Suttajit
Surinporn Likhitsathian
Chawanun Charnsil
Manit Srisurapanont
author_facet Narong Maneeton
Benchalak Maneeton
Pakapan Woottiluk
Sirijit Suttajit
Surinporn Likhitsathian
Chawanun Charnsil
Manit Srisurapanont
author_sort Narong Maneeton
title Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
title_short Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
title_full Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
title_fullStr Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
title_full_unstemmed Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: A meta-analysis of randomized controlled trials
title_sort comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent adhd: a meta-analysis of randomized controlled trials
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84948995338&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/44062
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