Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and impairing disorder affecting children, adolescents, and adults. Several treatment strategies are available that can successfully ameliorate symptoms, ranging from pharmacological to dietary interventions. Due to the increasing range of available options, an informed selection or prioritization of treatments is becoming harder for clinicians. This review aims to provide an evidence-based appraisal of the literature on ADHD treatment, supplemented by expert opinion on plausibility. We outline proposed mechanisms of action of established pharmacologic and non-pharmacologic treatments, and we review targets of novel treatments. The most relevant evidence supporting efficacy and safety of each treatment strategy is discussed. We review the individualized features of the patient that should guide the selection of treatments in a shared decision-making continuum. We provide guidance for optimizing initiation of treatment and follow-up of patients in clinical settings.
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Dr. Caye declares no conflicts of interest. Prof. Coghill reports grants from The European Union FP7 Programme and Shire; honoraria from Shire, Eli-Lilly, Novartis, and Janssen-Cilag; acted as an advisor to Shire and Lundbeck; and received royalties from Oxford University Press. Prof. Coghill was a member of British Association for Psychopharmacology ADHD, Depression and Bipolar Disorder Guideline groups. Prof. Swanson was a member of the advisory board and/or acted as a consultant for Medice and NLS Pharma in 2017. Prof. Rohde has been a member of the speakers’ bureau/advisory board and/or acted as a consultant for Eli-Lilly, Janssen-Cilag, Medice, Novartis, and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire. He also received travel awards from Novartis and Shire to attend the 2015 WFADHD and the 2016 AACAP meetings.
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Caye, A., Swanson, J.M., Coghill, D. et al. Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Mol Psychiatry 24, 390–408 (2019). https://doi.org/10.1038/s41380-018-0116-3
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DOI: https://doi.org/10.1038/s41380-018-0116-3
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