A literature review and meta-analysis on the effects of ADHD medications on functional outcomes

Heidi Boland; Maura DiSalvo; Ronna Fried; K Yvonne Woodworth; Timothy Wilens; Stephen V Faraone; Joseph Biederman

doi:10.1016/j.jpsychires.2020.01.006

A literature review and meta-analysis on the effects of ADHD medications on functional outcomes

J Psychiatr Res. 2020 Apr:123:21-30. doi: 10.1016/j.jpsychires.2020.01.006. Epub 2020 Jan 27.

Authors

Heidi Boland¹, Maura DiSalvo², Ronna Fried³, K Yvonne Woodworth⁴, Timothy Wilens⁵, Stephen V Faraone⁶, Joseph Biederman⁷

Affiliations

¹ Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA. Electronic address: hboland@partners.org.
² Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA. Electronic address: mdisalvo@partners.org.
³ Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA. Electronic address: rfried@partners.org.
⁴ Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA. Electronic address: kywoodworth@partners.org.
⁵ Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: twilens@partners.org.
⁶ Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA. Electronic address: sfaraone@childpsychresearch.org.
⁷ Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: biederman@helix.mgh.harvard.edu.

PMID: 32014701
DOI: 10.1016/j.jpsychires.2020.01.006

Abstract

Objective: To conduct a systematic review and meta-analysis of literature from large databases and registries to assess the effects of ADHD medication on associated functional outcomes.

Study design: A literature search was performed in PubMed, PsycINFO, MEDLINE, and Web of Science for articles published prior to January 2019. Sample size, age range, country of origin, medication type, number of functional events and non-events, odds ratios and hazard ratios, and means and standard deviations were extracted. Random-effects meta-analyses were conducted for 21 studies examining functional outcomes.

Results: 40 articles were included. The majority suggest a robust protective effect of ADHD medication treatment on mood disorders, suicidality, criminality, substance use disorders, accidents and injuries, traumatic brain injuries, motor vehicle crashes, and educational outcomes. Similarly, the meta-analyses demonstrated a protective effect of medication treatment on academic outcomes, accidents and injuries, and mood disorders.

Conclusions: These findings suggest that ADHD medication treatments are associated with decreases in the risks for a wide range of ADHD-associated functional outcomes supporting efforts aimed at early diagnosis and treatment of individuals with ADHD.

Keywords: ADHD; Functional outcomes; Medication adherence; Stimulants.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Accidents, Traffic
Attention Deficit Disorder with Hyperactivity* / drug therapy
Attention Deficit Disorder with Hyperactivity* / epidemiology
Databases, Factual
Humans
Odds Ratio
Proportional Hazards Models