Evidence map›Paper›PMID 42595937›Full record

ReviewCNS drugs2026

Candidate Clinico-Demographic Predictors or Moderators of Efficacy and Tolerability of Pharmacological Treatment in Attention-Deficit/Hyperactivity Disorder (ADHD): An Analysis of the MED-ADHD Repository of Randomised Controlled Trials.

Sulagna Roy, Guilherme Fusetto Veronesi, Sara Mannarini, Daniele Pirolo, Alessio Bellato, Samuele Cortese, Valeria Parlatini

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In one paragraph

Review in CNS drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sulagna RoySchool of Psychology, University of Southampton, Southampton, UK. S.roy@soton.ac.uk.
Guilherme Fusetto VeronesiDevelopmental Evidence Synthesis, Prediction, Implementation (EPI) Lab, Faculty of Environmental and Life Sciences, Centre for Innovation in Mental Health (CiMH), School of Psychology, University of Southampton, Highfield Campus, Building 44, Southampton, SO17 1BJ, UK.
Sara MannariniDepartment of Biomedical Sciences, Sect. Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
Daniele PiroloChild and Adolescent Neuropsychiatry Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.
Alessio BellatoSchool of Psychology, University of Southampton, Southampton, UK.
Samuele CorteseSchool of Psychology, University of Southampton, Southampton, UK.ORCID http://orcid.org/0000-0001-5877-8075
Valeria ParlatiniSchool of Psychology, University of Southampton, Southampton, UK.

Funding

NIHR NIHR303122
6 · The paper itself

Abstract

BACKGROUND AND

objectiveRandomised controlled trials (RCTs) have demonstrated that pharmacotherapy reduces symptoms of attention-deficit/hyperactivity disorder (ADHD) at a group level, but efficacy and tolerability vary across individuals. Clinico-demographic characteristics may act as predictors and/or moderators of treatment efficacy and tolerability, but systematic evidence remains limited. Therefore, we systematically analysed RCTs of ADHD medications to identify potential demographic and clinical predictors/moderators of efficacy and tolerability across the lifespan.

methodsRandomised controlled trials were identified from the MED-ADHD database ( https://med-adhd.org/ ), a repository of RCTs of medications for ADHD in children, adolescents and adults. The database is based on systematic searches of multiple electronic sources, including PubMed, BIOSIS Previews, CINAHL, the Cochrane Central Registry of Controlled Trials and EMBASE, and is also complemented by unpublished data obtained from manufacturers and study authors. We used the most recent (2026) version of MED-ADHD. The risk of bias was assessed using the revised Cochrane risk-of-bias tool (RoB 2).

resultsAmong the 171 RCTs screened, 62 assessed clinico-demographic factors as possible predictors or moderators of treatment efficacy and tolerability. Age was the most examined characteristic (56.4%) followed by, among the top five, psychiatric comorbidities (53.2%), sex (46.8%), baseline ADHD symptom severity (27.4%), and ADHD presentation (24.2%). Most RCTs reported no significant findings although there was preliminary evidence of associations with age (17.7%), psychiatric comorbidities (17.7%), baseline ADHD symptom severity (16.1%), sex (11.3%), and ADHD presentation (4.8%). Risk of bias was rated high in 37% of RCTs.

conclusionsStringent sample selection and reliance on group-level analyses may limit the power to detect predictors and moderators of treatment efficacy and tolerability in classical RCTs. Consequently, the current evidence provides limited and inconsistent guidance on clinically meaningful predictors/moderators. However, variables such as age, psychiatric comorbidities, sex, baseline severity and ADHD presentation have been the most frequently examined with positive findings and may hold promise. Future research should prioritise individual participant data meta-analyses of RCTs, alongside well-powered analyses of a comprehensive observational dataset, to more robustly investigate these associations and support treatment stratification through predictive models.

Identifiers

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Registered trials

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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.