Research has shown that there are few clinical comparisons available between the drugs for ADHD. As a result, parents seeking the best individual drug for their children with attention deficit hyperactivity disorder have little hard evidence to help make that choice.
There are few head-to-head clinical comparisons of many ADHD medications, despite the relatively large variety of drugs prescribed for ADHD and the prevalence of the condition among children and adults, according to a new review from the Oregon Evidence-based Practice Center at the Oregon Health and Science University.
The Oregon Evidence-based Practice Center makes available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes.
The majority of the head-to-head trials identified by the Oregon reviewers compared the widely prescribed ADHD medication Ritalin with other drugs. Most of these comparative trials were short in duration, included only a small number of patients and did not measure the long-term effects of the drugs.
As for safety, the researchers found that short-term, randomized controlled trials do not provide clear evidence that any one stimulant is any more tolerable than another or that non-stimulants are more tolerable than stimulants.
None of the trials compared how well the drugs performed in terms of improving academic performance, quality of life or social skills, the researchers found.
Stimulant medications such as Ritalin and amphetamines are most often prescribed for ADHD, but the Oregon study includes several types of ADHD medications that have never been examined before in a systematic review, including newer stimulants such as modafinil and non-stimulant drugs such as Strattera (atomoxetine), antihypertensive drugs such as guanfacine and older antipsychotic drugs such as clozapine.
Limited evidence suggests that the antihypertensive drugs clonidine and guanfacine reduce the severity of facial tics in children with ADHD, but the two drugs are not approved by the Food and Drug Administration for the treatment of ADHD.