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Báo cáo y học: " Comparative efficacy and acceptability of methylphenidate and atomoxetine in treatment of attention deficit hyperactivity disorder in children and adolescents: a meta-analysis"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Comparative efficacy and acceptability of methylphenidate and atomoxetine in treatment of attention deficit hyperactivity disorder in children and adolescents: a meta-analysis | Hanwella et al. BMC Psychiatry 2011 11 176 http www.biomedcentral.com 1471-244X 11 176 BMC Psychiatry RESEARCH ARTICLE Open Access Comparative efficacy and acceptability of methylphenidate and atomoxetine in treatment of attention deficit hyperactivity disorder in children and adolescents a meta-analysis Raveen Hanwella Madhri Senanayake and Varuni de Silva Abstract Background Psychostimulants and non stimulants are effective in the treatment of ADHD. Efficacy of both methylphenidate and atomoxetine has been established in placebo controlled trials. Direct comparison of efficacy is now possible due to availability of results from several head-to-head trials of these two medications. Methods All published randomized open label or double blind trials comparing efficacy of methylphenidate with atomoxetine in treatment of ADHD in children diagnosed using DSM-IV criteria were included. The outcome studied was ADHDRS-IVParent Inv score. The standardized mean difference SMD was used as a measure of effect size. Results Nine randomized trials comparing methylphenidate and atomoxetine with a total of 2762 participants were included. Meta-analysis did not find a significant difference in efficacy between methylphenidate and atomoxetine SMD 0.09 95 CI -0.08-0.26 Z 1.06 p 0.29 . Synthesis of data from eight trials found no significant difference in response rates RR 0.93 95 CI 0.76-1.14 p 0.49 . Sub group analysis showed a significant standardized mean difference favouring OROS methylphenidate SMD 0.32 95 CI 0.12-0.53 Z 3.05 p 0.002 . Immediate release methylphenidate was not superior to atomoxetine SMD -0.04 95 CI -0.19-0.12 Z 0.46 p 0.64 . Excluding open label trials did not significantly alter the effect size SMD 0.08 95 CI -0.040.21 Z 1.27 p 0.20 . All-cause discontinuation was used as a measure of acceptability. There was no significant difference in all cause discontinuation between atomoxetine and methylphenidate RR 1.22 95 CI 0.871.71 . There was significant .