ADHD remains a controversial disorder, particularly regarding its prevalence. Raman et al. (2018) report that the past few decades have witnessed an increase in diagnosis and pharmacological management of ADHD. Social constructionists have seen this as a reflection of the contextual nature of ADHD and question the validity of the disorder (Roy, 2008). Furthermore, when UK primary care witnessed a sharp increase in ADHD diagnoses and methylphenidate prescriptions, NICE (2013) issued a statement to avoid the use of stimulants in young people with mild-moderate ADHD because of concerns about the safety and effectiveness of these medications.
Three years ago there was considerable discussion and debate when a Cochrane review by Storebø et al (2015) questioned the efficacy and tolerability of methylphenidate in children and adolescents with ADHD.
In light of controversies such as these, the robust evidence provided by Cortese et al. (2018) ‘Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis’ is an important step forward in understanding ADHD pharmacotherapies.
The authors made the following conclusions:
All medications, except for modafinil in adults, were more efficacious than placebo for the short-term treatment of ADHD, and they were less efficacious and less well tolerated in adults than in children and adolescents.
Amphetamines were the most efficacious compounds in children, adolescents and adults.
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Paediatrics 