Comparative Efficacy Of Different Medication For Attention-deficit Hyperactivity Disorder In Children And Adolescents

Objective:To compare the remission time and functional improvement of different medication among children and adolescents with attention-deficit/hyperactivity disorder(ADHD).Methods:We analyze children and adolescents 6-17 years of age,with DSM-IV newly diagnosed and in the first-line treatment for more than 2 months,IQ?70 at different follow-up time points(2,4 and 6 months after take the medication)from June 2014 to December 2016 in our children care outpatient center,the Chinese Swanson,Nolan,and Pelham IV scale(SNAPIV)teachers and parents questionnaire core symptoms and impairment score changes.Results:A total of 145 children and adolescents met the diagnostic criteria and 135 take medication(93.1%).According to the exclusion criteria,37 cases were excluded,including 108 cases.The 72 patients completed the drug titration within 2 months according to the doctor's order.Among them,16 cases were changed due to severe gastrointestinal side effects,new sleep problems and other reasons,and the replacement rate was 22.2%.A total of 56 children were treated with single drug treatment for more than 2 months,which was divided into the methylphenidate group(n=42)and atomoxetine(n=14).2 months after treatment,ADHD core symptom was significantly improved both in the teachers and parents questionnaire of patients receiving methylphenidate than that before treatment(P<0.05).parents questionnaire: attention deficit 3.38±2.821 vs.6.51±1.846,hyperactivity 2.54±2.533 vs.4.50±2.837,teachers questionnaire: attention deficit 4.39±3.190 vs.6.33±2.153,hyperactivity 3.11±2.979 vs.4.45±2.917,symptom scores remained low in the fourth and sixth months after treatment.The functional impairment of parental questionnaires began to improve significantly from the fourth months(P<0.05),2.57±1.385 vs.1.56±1.688;The functional impairment of teachers questionnaires began to improve significantly from the sixth months(P<0.05),1.38±2.022 vs.2.78±1.858.6 months after treatment,the attention deficit symptom scores were significantly decrease both in the teachers and parents questionnaire of patients receiving Atomoxetine than that before treatment(P<0.05).parents questionnaire: 5.00±2.828 vs.6.07±2.433,teachers questionnaire: 2.50±2.380 vs.6.21±2.045;Functional impairment score decreased,but no significant statistical significance(P>0.05).Conclusion:Our findings show that both methylphenidate and atomoxetine treatments are associated with significantly improvements in ADHD core symptoms,but the time points are different.ADHD symptoms of patients receiving methylphenidate improved earlier than atomoxetine,Moreover,the function improvement was significant during 6months in methylphenidate group.However,mainly due to poor appetite,special co-morbidity and other factors,clinician choose atomoxetine.Therefore,the severity of the disease and the incidence of co-morbidity were higher than that in methylphenidate group,which may cause disturbance to the results of the study.In the future,it is necessary to expand the sample size and correct patients' co-morbidity and other factors,we can better compare the difference of functional impairment with methylphenidate and atomoxetine.