The most comprehensive review to date of ADHD treatments has found that medication for children and adults, and cognitive behavioural therapy for adults, remain the most effective approaches, backed by the strongest short-term trial evidence.
Researchers led by the Université Paris Nanterre (France), Institut Robert-Debré du Cerveau de l'Enfant (France), and the University of Southampton (UK) analysed over 200 meta-analyses covering different treatment types, participant groups, and clinical outcomes in a study published today [27 November 2027] in The BMJ.
The research was funded by public and peer-reviewed research grants from Agence Nationale de la Recherche (France), France 2030 program (France), and National Institute for Health and Care Research (UK).
To help people with attention deficit hyperactivity disorder (ADHD) and their clinicians make more informed, shared decisions, the team has created an interactive website that clearly presents the findings and the evidence behind each treatment based on the review ( ebiadhd-database.org ).
"We know that people with ADHD and their families are often overwhelmed by conflicting messages about which treatments work," says Professor Samuele Cortese, an NIHR Research Professor at the University of Southampton and senior lead author on the paper.
"We believe this study and the accompanying website provide the most authoritative, evidence-based, and accessible guidance currently available.
"The Evidence-Based Interventions for ADHD website provides freely available, evidence-based, and continuously updated information in an easy-to-understand way. To the best of our knowledge, this is the first platform in the world to do so based on such a rigorous synthesis of the available evidence."
Overall, five medications in children and adolescents, and two medications and cognitive behavioural therapy (CBT) in adults were shown to be effective while supported by a relatively robust evidence base. Critically, all this evidence was limited to the short-term, despite long-term treatment being common in clinical practice.
Treatments like acupuncture, mindfulness and exercise showed promise, but the evidence supporting their use was of a low quality due to small numbers of participants and risk of bias. The limitations applied to studies evaluating cognitive behavioural therapy in children and adolescents, as well as research on the long-term effects of mindfulness in adults, although mindfulness was the only intervention to demonstrate large beneficial effects at extended follow-up.
Dr Corentin Gosling, Associate Professor at the Paris Nanterre University and first lead author of the study, says: "Long waiting lists for mental health services are a major issue. Having incorrect information about treatments can make people's journeys even more difficult, by wasting time and money on non-evidence-based approaches, for example.
"By contrast, taking the time to review all treatment options within a shared decision-making process using the web app we developed (ebiadhd-database.org) can empower people with ADHD, leading to better treatment adherence, improved outcomes, and an overall better patient experience."
The findings generally complement current international clinical guidelines, not only by providing convenient access to current high-quality evidence, but also by covering interventions not usually mentioned in clinical guidelines.
The team hope this new project will achieve a similar impact in influencing clinical guidelines and practice as their previous project (ebiact-database.com), which looked at treatments for autism.
Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making is published in The BMJ and is available online.
