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Psychopharmacology and psychotherapy for the treatment of adults with ADHD—a systematic review of available meta-analyses

Published online by Cambridge University Press:  06 June 2013

Tais S. Moriyama*
Affiliation:
National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Divison of Child and Adolescent Psychiatry, Department of Psychiatry, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil
Guilherme V. Polanczyk
Affiliation:
National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil Divison of Child and Adolescent Psychiatry, Department of Psychiatry, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil
Fernanda S. Terzi
Affiliation:
Divison of Child and Adolescent Psychiatry, Department of Psychiatry, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil
Kauy M. Faria
Affiliation:
Divison of Child and Adolescent Psychiatry, Department of Psychiatry, University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil
Luis A. Rohde
Affiliation:
National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
*Corresponding
*Address for correspondence: Tais S. Moriyama, Instituto Nacional de Psiquiatria do Desenvolvimento, Rua Dr. Ovídio Pires de Campos 785, 3° andar, CEAPESQ, sala 09, CEP 05403-010 - São Paulo, SP, Brazil. (Email taismoriyama@gmail.com)

Abstract

Objective/Introduction

Attention-deficit/hyperactivity disorder (ADHD) in adult life is a prevalent condition. We systematically reviewed the literature available by searching for meta-analyses assessing pharmacological and psychosocial interventions for adults with ADHD.

Methods

Using wide-ranging search terms, we retrieved 191 titles from the PubMed and Cochrane databases. Two independent evaluators judged all abstracts. Only meta-analyses about the treatment of adults with ADHD were included. Information from meta-analyses found was systematically extracted by 3 independent evaluators.

Results

Eight meta-analyses were identified. Results from those meta-analyses suggest that stimulants are effective in decreasing ADHD symptoms on a short-term basis with a medium to large effect size (ES). Short-acting stimulants might be superior to long-acting stimulants, but no data on difference in adherence are available for the comparison of these two types of formulation. Bupropion is superior to placebo but less effective than stimulants. No conclusions about the impact of psychosocial interventions can be drawn based on meta-analyses so far.

Discussion

The efficacy of stimulants in reducing ADHD symptoms for adults is well documented in meta-analyses, but there is a concerning lack of meta-analysis about other treatment interventions.

Conclusion

The available meta-analytic literature does not cover questions of essential clinical relevance for adults with ADHD.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2013 

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Footnotes

Dr. Tais S. Moriyama receives financial support from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

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