SynthesisJournal of child and adolescent psychopharmacology2015
Meta-Analysis: Reduced Risk of Anxiety with Psychostimulant Treatment in Children with Attention-Deficit/Hyperactivity Disorder.
Synthesis in Journal of child and adolescent psychopharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- A meta-analytic review of the impact of ADHD medications on anxiety and depression in children and adolescents.European child & adolescent psychiatry · 2023Pooled it
- Discontinuation of pharmacological treatment of children and adolescents with attention deficit hyperactivity disorder: meta-analysis of 63 studies enrolling 11,788 patients.Psychopharmacology · 2017Pooled it
- Pre-Existing Comorbid Emotional Symptoms Moderate Short-Term Methylphenidate Adverse Effects in a Randomized Trial of Children with Attention-Deficit/Hyperactivity Disorder.Journal of child and adolescent psychopharmacology · 2020Trial
- Extended Release Guanfacine in Pediatric Anxiety Disorders: A Pilot, Randomized, Placebo-Controlled Trial.Journal of child and adolescent psychopharmacology · 2017Trial
- Observational
- Change in vital parameters at first methylphenidate administration as a predictor of treatment response at six-month follow-up.European child & adolescent psychiatry · 2026Article
- Remote monitoring of wide-ranging real-world changes in adults following ADHD medication initiation.Translational psychiatry · 2025Article
- Attention-deficit/hyperactivity disorder (ADHD) in adults: evidence base, uncertainties and controversies.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- ADHD in Adults with Epilepsy: A Guide for Neurologists.Epilepsy & behavior reports · 2025Article
- Examining the roles of working memory and trait anxiety on math achievement in children with ADHD.Neuropsychology · 2025Article
- Does age of ADHD medication initiation predict long-term risk of anxiety? A scoping review.PLOS mental health · 2025Article
- Adult ADHD and comorbid anxiety and depressive disorders: a review of etiology and treatment.Frontiers in psychiatry · 2025Review
- Effect of pharmacological treatment of attention-deficit/hyperactivity disorder on later psychiatric comorbidity: a population-based prospective long-term study.BMJ mental health · 2024Article
- Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- From Consensus Statement to Pills to Pixels: New Innovations in Attention-Deficit/Hyperactivity Disorder Care.Journal of child and adolescent psychopharmacology · 2024Review
- Anxiety and Somatic Symptoms in Children and Adolescents Diagnosed with Attention-Deficit Hyperactivity Disorder.Psychiatry journal · 2023Article
- Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP.Brain sciences · 2022Review
- ADHD and Anxiety Disorder Comorbidity in Children and Adults: Diagnostic and Therapeutic Challenges.Current psychiatry reports · 2022Review
- Effects of prolonged methylphenidate treatment on amygdala reactivity and connectivity: a randomized controlled trial in stimulant treatment-naive, male participants with ADHD.Psychoradiology · 2021Article
- The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder.Neuroscience and biobehavioral reviews · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveAnxiety is a commonly reported side-effect of psychostimulant treatment. Our goal was to quantify the risk of anxiety as a side effect of psychostimulant treatment for attention-deficit/hyperactivity disorder (ADHD).
methodsWe conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of psychostimulant medications in the treatment of children with ADHD. We used a fixed-effects meta-analysis to examine the risk ratio of anxiety reported as a side effect in children treated with psychostimulants compared with those treated with placebo. We used stratified subgroup analysis and meta-regression to examine the effects of stimulant type, dosage, duration of use, and trial design on the measured risk of anxiety.
resultsWe identified 23 studies involving 2959 children with ADHD for inclusion in our meta-analysis. The risk of anxiety associated with psychostimulant treatment was significantly lower than that experienced with placebo (relative risk [RR] = 0.86 [95% CI: 0.77, 0.95], z = -2.90, p < 0.05). Higher doses of psychostimulants were associated with a reduced measured risk of anxiety of psychostimulants when compared with placebo (β = -0.0039 [95% CI: -0.00718, -0.00064], z = -2.34, p = 0.019).
conclusionsMeta-analysis suggests that treatment with psychostimulants significantly reduced the risk of anxiety when compared with placebo. This finding does not rule out the possibility that some children experience increased anxiety when treated with psychostimulants, but suggests that those risks are outweighed by the number of children who experience improvement in anxiety symptoms (possibly as a secondary effect of improved control of ADHD symptoms). Clinicians should consider rechallenging children with ADHD who report new-onset or worsening anxiety with psychostimulants, as these symptoms are much more likely to be coincidental rather than caused by psychostimulants.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.