Type Of Attention Deficit Hyperactivity Disorder Research Articles

Transcranial Direct Current Stimulation in ADHD: A Systematic Review of Efficacy, Safety, and Protocol-induced Electrical Field Modeling Results.

Transcranial direct current stimulation (tDCS) is a promising method for altering cortical excitability with clinical implications. It has been increasingly used in neurodevelopmental disorders, especially attention-deficit hyperactivity disorder (ADHD), but its efficacy (based on effect size calculations), safety, and stimulation parameters have not been systematically examined. In this systematic review, we aimed to (1) explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients, (2) evaluate the safety of tDCS application, especially in children with ADHD, (3) model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols, and (4) discuss and propose advanced tDCS parameters. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a literature search identified 14 empirical experiments investigating tDCS effects in ADHD. Partial improving effects of tDCS on cognitive deficits (response inhibition, working memory, attention, and cognitive flexibility) or clinical symptoms (e.g., impulsivity and inattention) are reported in 10 studies. No serious adverse effects are reported in 747 sessions of tDCS. The left and right dorsolateral prefrontal cortex are the regions most often targeted, and anodal tDCS the protocol most often applied. An intensity of 2mA induced stronger electrical fields than 1mA in adults with ADHD and was associated with significant behavioral changes. In ADHD children, however, the electrical field induced by 1mA, which is likely larger than the electrical field induced by 1mA in adults due to the smaller head size of children, was sufficient to result in significant behavioral change. Overall, tDCS seems to be a promising method for improving ADHD deficits. However, the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes. Cortical regions involved in ADHD pathophysiology, stimulation parameters (e.g. intensity, duration, polarity, and electrode size), and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD. Developmental aspects of tDCS in childhood ADHD should be considered as well.

Neurological Soft Signs in Patients with Attention Deficit Hyperactivity Disorder Aged 6 to 18 Years Old at a University Hospital: A Cross-sectional Study

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children persisting into adulthood. Evidence suggests that the condition is etiologically related to delayed brain maturation. The detection of the presence of neurological soft signs can be a means to assess neuromaturation. The objective of this study was to assess the prevalence of neurological soft signs in ADHD patients and determine any correlation between the presence of neurological soft signs with age, gender, severity and type of ADHD which could give further insights into this disorder.

Trends in incidence rates of diagnosed attention-deficit/hyperactivity disorder (ADHD) over 12 years in Taiwan: A nationwide population-based study

We investigated time trends in the incidence rate (IR) of attention-deficit/hyperactivity disorder (ADHD) across the lifespan and potential factors affecting them using a Taiwanese population-based database. IR per 10,000 person-years (PY) of newly diagnosed ADHD based on ICD-9-CM was calculated annually for the total population, gender, 5 age groups, and 3 ADHD subtypes from 2000 to 2011. Among the 265,932 patients, IR increased from 7.92 to 13.92; the male-to-female ratio decreased from 3.61 to 2.90. The largest increase in IR was noted in young adults (19–30 years), followed by preschoolers (0–6 years), while the smallest increase was in adults (>31 years). The IR trends showed a more prominent increase in males than females among children, adolescents, and young adults, yet a reserved relationship existed among adults, with a more prominent increase in women. The combined type of ADHD exhibited a prominently increasing trend in the child/adolescent group (age≦18) and the inattentive type ADHD in the adult group (age>18). In conclusion, the ADHD IR is increasing with distinct differences among age, sex, and subtypes. The diminishing gap between those who need treatment and those actually treated might partly contribute to this trend, especially among young adults, preschoolers, and females.

Objective ADHD Diagnosis Using Convolutional Neural Networks Over Daily-Life Activity Records.

This paper proposes an end-to-end methodology for automatic diagnosis of the combined type of ADHD. Diagnosis is based on the analysis of 24 hour-long activity records using Convolutional Neural Networks to classify spectrograms of activity windows. We achieve up to [Formula: see text] average sensitivity, [Formula: see text] specificity and AUC values over [Formula: see text]. Overall, our figures overcome those obtained by actigraphy-based methods reported in the literature as well as others based on more expensive (and not so convenient) acquisition methods. These results reinforce the idea that combining deep learning techniques together with actimetry can lead to a robust and efficient system for objective ADHD diagnosis. Reliance on simple activity measurements leads to an inexpensive and non-invasive objective diagn-ostic method, which can be easily implemented with daily devices.

The Theta/Beta Ratio as an Index of Cognitive Processing in Adults With the Combined Type of Attention Deficit Hyperactivity Disorder.

An elevated theta/beta ratio in the EEG has long been observed among individuals with Attention Deficit Hyperactivity Disorder (ADHD). The theta/beta ratio was previously hypothesised to be an index of arousal, but a number of studies failed to find any association between the ratio and indices of arousal, instead proposing that the theta/beta ratio may actually be indicative of cognitive processing. This hypothesis was tested by Clarke et al using a sample of healthy adults, with results indicating that the theta/beta ratio correlated with a marker of cognitive processing (P300 latency in an auditory oddball task), while P300 amplitude correlated with an arousal marker (alpha power). The aim of this study was to test whether similar results could be found in a sample of 41 adults with the combined type of ADHD. EEGs were recorded during an eyes-closed resting condition and an auditory oddball task. Results demonstrated that the theta/beta ratio correlated significantly with P300 latency. Absolute alpha power did not correlate significantly with P300 amplitude or P300 latency. These results support the hypotheses that the theta/beta ratio is a marker of cognitive processing capacity in both the general population and in participants with ADHD, and that the alpha/arousal linkage is anomalous in ADHD.

Combining functional near-infrared spectroscopy and EEG measurements for the diagnosis of attention-deficit hyperactivity disorder

Recently multimodal neuroimaging which combines signals from different brain modalities has started to be considered as a potential to improve the accuracy of diagnosis. The current study aimed to explore a new method for discriminating attention-deficit hyperactivity disorder (ADHD) patients and control group by means of simultaneous measurement of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). Twenty-three pre-medicated combined type ADHD children and 21 healthy children were included in the study. Nonlinear brain dynamics of subjects were obtained from EEG signal using Higuchi fractal dimensions and Lempel–Ziv complexity, latency and amplitude values of P3 wave obtained from auditory evoked potentials and frontal cortex hemodynamic responses calculated from fNIRS. Lower complexity values, prolonged P3 latency and reduced P3 amplitude values were found in ADHD children. fNIRS indicated that the control subjects exhibited higher right prefrontal activation than ADHD children. Features are analyzed, looking for the best classification accuracy and finally machine learning techniques, namely Support Vector Machines, Naive Bayes and Multilayer Perception Neural Network, are introduced for EEG signals alone and for combination of fNIRS and EEG signals. Naive Bayes provided the best classification with an accuracy rate of 79.54% and 93.18%, using EEG and EEG-fNIRS systems, respectively. Our findings demonstrate that utilization of information by combining features obtained from fNIRS and EEG improves the classification accuracy. As a conclusion, our method has indicated that EEG-fNIRS multimodal neuroimaging is a promising method for ADHD objective diagnosis.

Dikkat Eksikliği Hiperaktivite Bozukluğunda Duygu Düzenleme ve İlişkili Faktörlerin İncelenmesi

Aim Emotion regulation difficulties (ERD) such as anger, irritability and frustration intolerance leading to severe functional losses may be observed in attention deficit-hyperactivity disorder (ADHD). The purpose of this study was to compare children and adults diagnosed with ADHD and a healthy control group in terms of emotion regulation characteristics and to examine factors potentially associated with ERD. Method The study was performed with 72 children/adults aged 6-18 diagnosed with ADHD based on DSM-V diagnostic criteria at the XXXXXX Child and Adolescent Psychiatry Polyclinic, Turkey, and 30 healthy controls. The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL), a semi-structured interview form, was used to determine comorbidities. ERD scores (ERD=attention+anxiety/depression+aggression subscales) were determined using the Childhood Behavior Checklist (CBCL). Results Mean ERD scores were 189.45±19.33 in the ADHD group and 164.13±9.94 in the healthy control group. A significant difference was determined in ERD scores between the two groups (p˂0.001**). When the ADHD group was evaluated in terms of clinical characteristics, comorbid psychiatric disorders were not associated with ERD, but combined type ADHD characteristics emerged as significant predictors for ERD (r=0.43, r2=0.18, p=0.001**). Conclusion The results of this research revealed significantly greater ERD in individuals diagnosed with ADHD compared to healthy controls, and that combined type ADHD is a predictor for ERD. Since ERD accompanying ADHD lead to greater function loss in the individual and are associated with persistence of the disorder in adulthood, these are important clinical characteristics also requiring evaluation during the diagnosis and treatment of ADHD.

Selecting Effective Herbal Medicines for Attention-Deficit/Hyperactivity Disorder via Text Mining of Donguibogam.

Objective Several attempts have been made to reduce the harmful side effects and increase the efficacy of current drugs used to treat attention-deficit/hyperactivity disorder (ADHD). Many articles have studied medicinal herbs as an effective supplement in treating ADHD. In a similar manner, this study provides foundational data to identify herbs that are potentially effective in treating ADHD by text mining of Donguibogam, which is a comprehensive summation of the important traditional principles and practices of Korean medicine. Methods Text mining was performed for 3833 herbal prescriptions and 1108 medicinal herbs comprising prescriptions listed in Donguibogam. The first step was frequency analysis followed by chi-square test, which is a statistical hypothesis test. Results and Conclusions Twelve medicinal herbs were selected for each ADHD subtype: hyperactivity ADHD type (ADHD-PHI) and attention-deficit ADHD type (ADHD-PI). Compared to previous research on traditional literature, a newer and more efficient methodology of selecting herbal medicines was developed in this process.

Altered microRNA 5692b and microRNA let-7d expression levels in children and adolescents with attention deficit hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Its etiology is not clearly understood yet, but neurobiological, genetic and environmental factors are shown to play a role. The relationship between ADHD and miRNAs has been studied quite recently, and few studies have been conducted up to now. In this study, peripheral blood expression levels of miR-5692b, miR-let-7d, miR-124-3p, miR-4447 and miR-107 of 30 children and adolescents with combined type ADHD were compared to 30 healthy controls to understand the roles of these miRNAs in the ADHD etiopathogenesis. Compared to controls, levels of miR-5692b (p = 0.006) were found higher and levels of miR-let-7d (p = 0.017) were found lower in the ADHD group. There was no significant difference in terms of miR-124-3p, miR-4447, and miR-107 levels between the groups. In conclusion, our findings support other studies suggesting the importance of miRNAs in the pathogenesis of ADHD. Regarding the regulatory role of miRNAs in gene regulation, their contribution to etiopathogenesis and heterogeneity of ADHD should be investigated further.

The amygdala in adolescents with attention-deficit/hyperactivity disorder: Structural and functional correlates of delay aversion

Objectives Recent magnetic resonance imaging (MRI) studies implicate structural alterations of amygdala, a brain region responsible for processing and experiencing negative emotions, in adolescents with attention-deficit/hyperactivity disorder (ADHD). Here we examined ADHD-related structural correlates of amygdala functional activity elicited during a functional MRI task designed to test behavioural and brain responses to the imposition of delay – an event known to both elicit amygdala hyperactivation and aversity in ADHD. Methods Structural MRI scans from 28 right-handed male adolescents with combined type ADHD and 32 age-matched controls were analysed. Regional grey matter volumes of ADHD and control participants (P[FWE] < 0.05) were correlated with delay aversion self-ratings and neural activity in response to delay-related cues on the Escape Delay Incentive fMRI task. Results ADHD was associated with significantly reduced volumes in bilateral amygdala, parahippocampal and temporal gyrus (P[FWE] < 0.05), greater basolateral amygdala activation to delay-related cues (P[FWE] < 0.05) and higher delay aversion self-ratings. Amygdala volume reductions were significantly correlated with, and statistically mediated the pathway from ADHD to, delay-cue-related amygdala hyperactivity (P < 0.01) and self-reported delay aversion (P < 0.01). Conclusions We provide the first evidence of the functional significance of reduced amygdala volumes in adolescents with ADHD by highlighting its relation to delay-induced brain activity that is linked to delay aversion.

Prevalence of attention deficit hyperactivity disorder, gender difference and its co morbidity among urban school children in a city of southern Rajasthan, India

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed disorders of childhood (3-5%). The main characteristics of attention deficit hyperactivity disorder are inattention, hyperactivity, and impulsivity. The Objective of this study was to study prevalence of ADHD in school aged children.Methods: A cross sectional descriptive school-based study was conducted in a private school of Udaipur from January 2017 to September 2018. All eligible students were included. Total 1200 students were enrolled. They were assessed for the presence of ADHD using INCLEN diagnostic tool and those found positive were further assessed for the presence of co-morbid conditions using child behavior checklist (CBCL).Results: In present study out of total 1200 students 730(60.83%) were male and 470(39.17%) were female. 76 (6.3%) students out of 1200 were ADHD Positive. ADHD was more common in male students (73.7%), urban locality (57.89%), in age group 6 to 9 years (44.7%) and higher economic class (46.1%). Hyperactivity-Impulsivity type was most common type (51.32%). Male students had predominance of hyperactivity (60.7%) whereas in female student’s inattention type was predominant (45%). Aggressive Behavior (19.6%) and rule breaking behavior (80.4%) was more common in male. Somatic complaints were more common in females (60%). Oppositional defiant disorder was observed in male (21.4%) and female (10%) students. 15.8% of ADHD students had learning disorder.Conclusions: Present study shows 6.3% prevalence of ADHD. Hyperactivity type of ADHD was more common in boys, while Inattention type was more common in girls. Among associated co morbid conditions - aggressive behavior, rule breaking behavior and oppositional defiant disorder (ODD) was found to be more prevalent in boys while anxious behavior, somatic complaints and social problems were more commonly found in girls. Thought problems, learning disorders and conduct disorders are also observed in ADHD students.

Test of Everyday Attention for Children (TEA-Ch): Greek Normative Data and Discriminative Validity for Children with Combined Type of Attention Deficit-Hyperactivity Disorder

ABSTRACT We examined the utility of the Test of Everyday Attention for Children (TEA-Ch) for Greek children. Discrete and regression-based norms, controlling for demographic characteristics and intelligence, were derived from the performance of 172 children. We also assessed the ability of the TEA-Ch to differentiate children with ADHD-Combined Type (ADHD-C) from healthy matched peers. Children with ADHD-C displayed dysfunction in multiple attentional domains. Discriminant function analysis indicated that two subtests (Sky Search and Walk, Don’t Walk) correctly classified 84.2% of children with ADHD-C.

Clinical correlates of restrictive type Attention Deficit Hyperactivity Disorder in adolescents

Clinical correlates of restrictive type Attention Deficit Hyperactivity Disorder in adolescents

Effect of Methylphenidate on Blood Glucose Profile in an Adolescent Male with Type 1 Diabetes Mellitus, A Case Report

Introduction: Attention deficit/hyperactivity disorder (ADHD) is the commonest childhood neuro-developmental disorder. Methylphenidate (MPH) is a psychostimulant commonly prescribed in clinical practice to treat patients with ADHD. Comorbidity of Type 1Diabetes mellitus (T1D) and ADHD in children can be encountered in clinical practice. However, the impact of MPH on the blood glucose profile is scarcely addressed in the literature. Methods: Multiple blood glucose concentrations (BGCs) obtained from a 12 years old male with T1D (under treatment with continuous insulin infusion) and comorbid ADHD have been evaluated after having received 2 dose levels (5 mg and 7.5 mg) methylphenidate (MPH). BGCs were assessed at 6 time points, over 3 weeks period. During the assessment periods, the patient had similar daily feeding en activity conditions and unchanged background insulin infusion The means of the values obtained after each dose level were compared with each other and with those obtained before commencement of MPH treatment. Results: Three clinically relevant findings were encountered. The mean values of fasting Blood glucose levels (BGLs) obtained during MPH treatment periods were lower than that obtained before MPH use, respectively -28% and -23% below BL for the 5 and 7.5 mg dose levels. The means of other post-MPH treatment values obtained, through the day, were higher than that obtained before treatment, respectively +39% and +40% above Base line (BL). In addition, increasing MPH dose level was associated with increased BGL at all assessment time points. Conclusion: Methylphenidate seems to dysregulate blood glucose levels in patients with type 1 diabetes mellitus. This might lead to serious consequences, including both microvascular and macrovascular diseases, particularly in vulnerable subjects such as those who receive medication for a long period of time. Commencement of treatment with and up-titration of MPH dose in ADHD patients with comorbid T1D requires close monitoring of blood glucose concentrations to avoid potential blood glucose excursions that might lead to unwanted complications.

Epileptiform activities in the EEG of Children with Attention Deficit Hyperactivity Disorder Rama Ahmed Mahmoud 1 Olweya Mohamed Abdel Baky2, Hanan Hosny Abdel Aleem 3 and Reham Sabrey Tarkan4 1 Medical Studies Department, Faculty of Postgraduate Childhood Studies, Ain Shams University. 2 Professor of child psychiatry, Faculty of Post Graduate Childhood Studies. 3 Professor of Clinical Neurophysiology, Faculty of medicine,

Introduction: Attention deficit hyperactivity disorder (ADHD) is characterized by heightened impulsivity, inattention, and hyperactivity. One of changes in EEG of ADHD children is epileptiform activity (EA), characterized by recording of excessive neuronal discharge. Objectives: identifying encephalographic epileptiform activity in (ADHD) children and its relation to types of ADHD. Methodology: All ADHD cases from the Centre of special need children in the year of 2015 were examined (4 days / week), 50 cases were enrolled and EEG epileptiform abnormalities were recorded. Ethical aspects: Approval from the ethical committee of the Faculty of childhood postgraduate studies, Ain Shams University. Limitations: refusal of the caregiver to perform the EEG.

Assessment of prevalence of attention deficit hyperactivity disorder among schoolchildren in selected schools

Background:Attention deficit hyperactivity disorder (ADHD) is considered the most common neurodevelopmental disorder of childhood and can continue through adolescence and adulthood. Global impairment in children with ADHD increases with increasing number of concurrent disorders. The presence of ADHD in childhood increases the likelihood of additional difficulties in academic performance, social interactions, and low self-esteem developing into adolescents and young adults.Aims:The study aims to (i) to determine the prevalence of ADHD among schoolchildren at selected schools in Kancheepuram district, (ii) to find the agreement between parent and teacher reports, and (iii) to associate the prevalence of ADHD among schoolchildren with their selected demographic variables.Settings and Design:A quantitative research approach with cross-sectional research design was adopted for the study. The study focused on primary schoolchildren from the selected schools in Kancheepuram district.Materials and Methods:Totally 3253 children aged between 8 and 11 years were enumerated from the selected six schools in Kancheepuram district after obtaining informed consent from their caregivers. The presence of ADHD was assessed using Conners’ Teacher–Parent Rating Scale given to caregivers and teachers and confirmed with the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for ADHD.Results:The analysis revealed the overall prevalence of ADHD to be 8.8%. The subtypes of ADHD were categorized as 124 (43.3%) for inattentive type, 124 (43.3%) for hyperactive type, and 38 (13.2%) for combined type of ADHD.Conclusion:The present study shows a high prevalence of ADHD among primary schoolchildren.

Impact of allergy on children with attention deficit hyperactivity disorder.

Background. Attention deficit hyperactivity disorder (ADHD) is commonly present worldwide, causing serious problems to those affected. ADHD was suggested to be secondary to allergic disorder or its medication. Both ADHD and allergy depend on complex environmental and genetic interaction, and they meet the hypersensitivity criteria. Objective. Detect the percentage of allergy in ADHD children, the common allergic disorders and allergens, and the effect of allergy on symptom and severity of ADHD. Material and methods. 100 children with ADHD were subjected to psychiatric assessment for ADHD type and severity, history of allergy, skin prick test to common environmental allergens, serum total IgE levels and open food challenge. Co-morbid neuropsychiatric disorders, below average intelligence quotient (IQ), and chronic illnesses were excluded. A control of 60 healthy children was chosen to compare the results of skin prick test and serum total IgE levels. Results. 35 ADHD children (35%) were allergic. Most cases had combined allergic rhinitis and bronchial asthma (25%). Common allergens were hay dust (43%) followed by different pollens (37.5%). There were statistical significant differences between coexistence of allergy, type of ADHD, early onset and severity of symptoms. Conclusion. Children with ADHD had an increased prevalence of allergic diseases. Evaluation of allergy in ADHD is mandatory, to decrease the burden of the condition.

Correlates of nicotine dependence in men with childhood attention-deficit/hyperactivity disorder: a 33-year follow-up.

Identify correlates of nicotine dependence [lifetime (l) and ongoing (o)] in adults with attention-deficit/hyperactivity disorder (ADHD) in childhood. We conducted a 33-year prospective follow-up of boys (mean age 8) with combined type ADHD (n = 135/207, 65% original sample). Correlates of nicotine dependence in adulthood were selected from characteristics obtained in childhood and adolescence. Among selected childhood features, only immature behavior was significantly related to nicotine dependence (OR(o) = 0.29, p = 0.02), indexing decreased risk. In contrast, several adolescent variables significantly correlated (p < 0.01) with nicotine dependence at mean age 41, including alcohol substance use disorder (SUD, OR(l) = 4.97), non-alcohol SUD (OR(o) = 4.33/OR(l) = 10.93), parental antisocial personality disorder (OR(l) = 4.42), parental SUD (OR(l) = 3.58), dropped out of school (OR(l) = 2.29), impulsivity (OR(o) = 1.53/OR(l) = 1.59), hyperactivity (OR(o) = 1.38), and number of antisocial behaviors (OR(o) = 1.10/OR(l) = 1.14). Results highlight the role of adolescent psychopathology in the development of nicotine dependence, motivating prospective longitudinal efforts to better define the developmental trajectories of risk and protection.

Oxidative stress contribution to attention deficit hyperactivity disorder in children with epilepsy

Children with epilepsy have a high incidence of attention deficit hyperactivity disorder (ADHD). Oxidation stress and disturbed neurotransmitters are suggested mechanisms; however, their role is not fully explored. This study evaluates the association between circulating malondialdehyde as an oxidation stress marker, apelin neuropeptide, and ADHD in children with epilepsy. Fifty children with epilepsy of unknown etiology, of which 25 have ADHD, as well as 35 healthy children were included. Serum levels of malondialdehyde and apelin were estimated. We investigated the association between seizure severity, response to medications, malondialdehyde, apelin levels, and ADHD in children with epilepsy. Serum malondialdehyde and apelin levels were higher in children with epilepsy, especially those with ADHD. Malondialdehyde and apelin levels have significant positive correlation with the Chalfont Seizure Severity Score. Regression analysis showed that elevated malondialdehyde is an independent risk factor for ADHD in children with epilepsy (OR: 1.401, 95%CI: 1.056–1.859, p= 0.02). No significant association was found between malondialdehyde and apelin levels and the type of epilepsy or ADHD. Longer duration of epilepsy, increased seizure severity, and uncontrolled seizures are associated with increased oxidation stress, which further increased susceptibility for ADHD. In spite of elevated apelin in children with ADHD, the elevation did not increase the risk of ADHD in children with epilepsy.

Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults.

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset psychiatric disorder that can persist into adulthood in up to 50% of patients. From a clinical point of view, ADHD is characterized by hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours. The presence of other disorders occurring at the the same time is also common, especially mood disorders and substance abuse. It seems that amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms. We found seven studies, which enrolled 1091 patients. These studies compared amphetamines to placebo and three of them also compared amphetamines with other drugs: guanfacine, modafinil and paroxetine. Three amphetamine derivatives were investigated: dexamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS). Treatment length ranged from two to 20 weeks. All amphetamines improved ADHD symptoms but overall they did not make people more likely to stay in treatment and were associated with a higher risk of treatment ending early due to adverse events. One type of amphetamine, mixed amphetamine salts, did, however, increase retention in treatment. We found no evidence that higher doses worked better than lower ones. We did not find any difference in effectiveness between immediate-release and sustained-release formulations. Therefore, it appears that short-term treatment with amphetamines reduces ADHD symptoms, but studies assessing the effects of amphetamines for longer periods of time are needed.