A Meta-analyses Comparing Atomoxetine with Methylphenidate for Treatement of Children with Attention- Deficit/ Hyperactivity Disorder_Chinese Journal of Evidence-Based Medicine

Authors：

XV Peiru ¹ , FANG Zhimin ²

1. The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China2. The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China;

Corresponding author：

Keywords：

Atomoxetine; Methylphenidate; Attention-deficit/hyperactivity disorder; Systematic review

DOI：

10.7507/1672-2531.20090065

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Objective 　To assess atomoxetine and methylphenidate therapy for attention- deficit/ hyperactivity disorder (ADHD) .
Methods 　We electronically searched the Cochrane Library (Issue 2, 2008), PubMed (1970 to 2008), MEDLINE (1971 to 2008), EMbase (1971 to 2008), Medscape (1990 to 2008), CBM (1978 to 2008), and NRR (1950 to 2008). We also hand-searched some published and unpublished references. Two independent reviewers extracted data. Quality was assessed by the Cochrane Reviewer’s Handbook 4.0. Meta-analysis was conducted by The Cochrane Collaboration’s RevMan 4.2.8 software.
Results 　We finally identified 3 randomized controlled trials that were relevant to the study. Treatment response (reducing ADHD-RS Inattention subscale score) was significantly greater for patients in the methylphenidate group than in the atomoxetine group with WMD= – 1.79 and 95%CI – 2.22 to 1.35 (P lt;0.000 01). There was no statistical difference in other outcome measures between two groups (P gt;0.05).
Conclusions 　The effectiveness and tolerance of methylphenidate and atomoxetine are similar in treatment of ADHD. Further large randomized, double blind, placebocontrolled trials with end-point outcome measures in long-term safety and efficacy are needed.

Citation： XV Peiru,FANG Zhimin. A Meta-analyses Comparing Atomoxetine with Methylphenidate for Treatement of Children with Attention- Deficit/ Hyperactivity Disorder. Chinese Journal of Evidence-Based Medicine, 2009, 09(3): 346-349. doi: 10.7507/1672-2531.20090065 Copy

1.	Barr CL, Kroft J, Feng Y, et al. The norepinephrine transporter gene and attention-deficit hyperactivity disorder. Am J Med Genet, 2002, 114(3): 255-259.
2.	秦炯. 注意缺陷多动障碍主要诊断标准简介与比较. 实用儿科临床杂志, 2006, 21(12): 799-800.
3.	SteerCR. Managing attention deficit/ hyperactivity disorder: unmetneeds and future directions. Arch Dis Child, 2005, 90(Suppl I):19-25.
4.	Elia J. Drug treatment for hyperactive children: therapeutic guidelines. Drugs, 1993, 46: 863-871.
5.	Kratochvil CJ, Wilens TE, Greenhill LL, et al. Effects of Long-Term Atomoxetine Treatment for Young Children With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry, 2006, 45(8): 919-927.
6.	Kratochvil CJ, Heiliqenstein JH, Dittmann R, et al. Atomoxetine and methylphenidate treatment in children with ADHD: a prospective, randomized, open-label trial. J Am Acad Child Adolesc Psychiatry, 2002, 41(7): 776-784.
7.	Kemner JE, Starr HL, Ciccone PE, et al. Outcomes of OROS methylphenidate compared with atomoxetine in children with ADHD: a multicenter, randomized prospective study. Am J Cardiol, 2004, 93(8): 990-996.
8.	徐通, 周翊, 魏宏伟, 等. 托莫西汀和哌甲酯治疗儿童注意缺陷多动障碍的疗效和安全性比较. 中国实用儿科杂志, 2008, 23(7): 499-501.
9.	Pliszka S, AACAP Work Group on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Adolesc Psychiatry, 2007, 46(7): 894-921.
10.	Michelson d, Buitelaar Jk, DanckaertsM, et al. Relapse prevention in pediatric patients with ADHD treated with atomoxetine: A randomized, double-blind, placebo-controlled Study. J Am Acad Child Adolesc Psychiatry, 2004, 43(7): 896.

1. Barr CL, Kroft J, Feng Y, et al. The norepinephrine transporter gene and attention-deficit hyperactivity disorder. Am J Med Genet, 2002, 114(3): 255-259.
2. 秦炯. 注意缺陷多动障碍主要诊断标准简介与比较. 实用儿科临床杂志, 2006, 21(12): 799-800.
3. SteerCR. Managing attention deficit/ hyperactivity disorder: unmetneeds and future directions. Arch Dis Child, 2005, 90(Suppl I):19-25.
4. Elia J. Drug treatment for hyperactive children: therapeutic guidelines. Drugs, 1993, 46: 863-871.
5. Kratochvil CJ, Wilens TE, Greenhill LL, et al. Effects of Long-Term Atomoxetine Treatment for Young Children With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry, 2006, 45(8): 919-927.
6. Kratochvil CJ, Heiliqenstein JH, Dittmann R, et al. Atomoxetine and methylphenidate treatment in children with ADHD: a prospective, randomized, open-label trial. J Am Acad Child Adolesc Psychiatry, 2002, 41(7): 776-784.
7. Kemner JE, Starr HL, Ciccone PE, et al. Outcomes of OROS methylphenidate compared with atomoxetine in children with ADHD: a multicenter, randomized prospective study. Am J Cardiol, 2004, 93(8): 990-996.
8. 徐通, 周翊, 魏宏伟, 等. 托莫西汀和哌甲酯治疗儿童注意缺陷多动障碍的疗效和安全性比较. 中国实用儿科杂志, 2008, 23(7): 499-501.
9. Pliszka S, AACAP Work Group on Quality Issues. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Adolesc Psychiatry, 2007, 46(7): 894-921.
10. Michelson d, Buitelaar Jk, DanckaertsM, et al. Relapse prevention in pediatric patients with ADHD treated with atomoxetine: A randomized, double-blind, placebo-controlled Study. J Am Acad Child Adolesc Psychiatry, 2004, 43(7): 896.

Chinese Journal of Evidence-Based Medicine

A Meta-analyses Comparing Atomoxetine with Methylphenidate for Treatement of Children with Attention- Deficit/ Hyperactivity Disorder

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