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Psych Congress NetworkSlight Symptom Gains but More Dropouts with Unlicensed Stimulant Doses in ADHD

Unlicensed Doses of Stimulants May Not Offer Additional Benefits for Adults with ADHD

This study provides an in-depth analysis of the impact of stimulant doses on treatment outcomes in adults with ADHD, with a particular focus on the comparison between licensed and unlicensed doses. The findings suggest that while unlicensed doses may lead to additional symptom reduction, the gains are small and come with an increased risk of adverse events.

Study Design

  • The study included 47 randomized clinical trials involving 7714 participants.
  • The average age of the participants was 35 years, with a standard deviation of 11 years.
  • 56% of the participants were male.
  • The study used aggregate data, synthesized in random-effects dose-response meta-analyses and network meta-analyses.

Key Findings

  • For methylphenidate, dose-response curves indicated additional reductions of symptoms with increments in doses, but the gains were progressively smaller and accompanied by an increased risk of adverse events dropouts.
  • Unlicensed doses of methylphenidate were associated with greater reductions of symptoms compared with licensed doses, but the additional gain was small and accompanied by an increased risk of adverse event dropouts.
  • For amphetamines, the dose-response curve approached a plateau and increments in doses did not indicate additional reductions of symptoms, but there were continued increments in the risk of adverse event dropouts.
  • Network meta-analysis did not identify differences between unlicensed and licensed doses of amphetamines for reductions of symptoms.

HCN Medical Memo
According to the CDC, about 6 million children aged 3–17 years have been diagnosed with ADHD. Boys (13%) are more likely to be diagnosed with ADHD than girls (6%).

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