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Oxford study reveals stimulants and atomoxetine as most effective adult ADHD treatments, based on analysis of 113 clinical trials with 14,800+ participants. Research provides crucial guidance for healthcare providers while highlighting need for personalised treatment approaches.

Research led by Oxford University has identified the most effective treatments for managing Attention Deficit Hyperactivity Disorder (ADHD) in adults, providing crucial guidance for healthcare providers and patients.

The comprehensive study, supported by the NIHR Applied Research Collaboration Oxford and Thames Valley, found that two types of medication – stimulants and atomoxetine – are the most effective at reducing ADHD symptoms.

Unlike stimulants, atomoxetine works by increasing levels of noradrenaline, a natural chemical in the brain that helps people concentrate and control impulses. While effective, some patients experience side effects such as changes in blood pressure, nausea, or trouble sleeping, highlighting why treatment choices need to be tailored to each individual.

Researchers analysed data from 113 clinical trials involving over 14,800 participants worldwide. They compared the effectiveness of different treatments, including medications, psychological therapies, and brain stimulation techniques.

Key findings:

  • Stimulant medications (including methylphenidate, lisdexamfetamine, and dexamfetamine) effectively improve concentration and reduce impulsive behaviour
  • Atomoxetine also works well, though some patients experience side effects
  • Non-drug treatments like cognitive behavioural therapy showed some benefits, but evidence was less strong

"Given the concerns around the safety of ADHD medications, there's a pressing need to better understand the benefits and risks of different treatments," explains Dr Edoardo G Ostinelli, Senior Researcher at Oxford University whose DPhil work is supported by the ARC OxTV. "This research helps lay the groundwork for more informed, patient-centered care."

The study highlights the importance of personalised treatment decisions, as different approaches may work better for different people. However, researchers note that more research is needed on long-term effects, as most studies only followed patients for up to 12 weeks.

ADHD affects around 2-5% of adults globally, with symptoms persisting from childhood in up to 75% of cases. The condition can significantly impact daily life, making effective treatment crucial.

Professor Andrea Cipriani, the study's senior co-author, emphasises that while these medications show clear short-term benefits, "it's vital to explore sustainable treatment options and their effects on overall well-being."

The research findings come at a crucial time, as awareness of adult ADHD continues to grow. Symptoms can include difficulty maintaining attention, impulsiveness, and problems with organisation – all of which can significantly impact work, relationships, and daily life. Despite affecting millions of adults worldwide, many people remain undiagnosed or struggle to access appropriate treatment.

The study also highlighted important gaps in current research. "While we now have strong evidence for several treatment options, we need more long-term studies," explains Professor Cortese from the University of Southampton. "Most current research only follows patients for up to 12 weeks, but ADHD is often a lifelong condition. Understanding how these treatments perform over longer periods is crucial for better patient care."

ADHD affects around 2-5% of adults globally, with symptoms persisting from childhood in up to 75% of cases. The condition can significantly impact daily life, making effective treatment crucial.

The research represents a collaborative effort across multiple organisations. The study was funded by the National Institute for Health and Care Research (NIHR) through a Research for Patient Benefit grant to Professor Samuele Cortese, NIHR Research Professor at the University of Southampton. The work was also supported by the NIHR Applied Research Collaboration Oxford and Thames Valley and conducted at the NIHR Oxford Health Clinical Research Facility. The research team worked closely with people with lived experience of ADHD to ensure the study addressed real-world needs and concerns.

The research was published in The Lancet Psychiatry and was funded by the National Institute for Health and Care Research (NIHR).