Families struggling to decide how to treat attention-deficit/hyperactivity disorder (ADHD) now have access to a new evidence-based tool that compares the benefits and risks of everything from stimulant medications to cognitive behavioral therapy.

Researchers have launched a website that summarizes the data from 115 randomized controlled trials on the benefits and harms of 15 ADHD treatments into one simple, interactive table.

The point of the research and tool—which was publicly funded in Europe—was to gather and present the highest-quality evidence in a simple format to people with ADHD and their families, who are often overwhelmed with treatment choices.

“Our goal is not to drive medication use up or down, but to facilitate shared decision-making,” Corentin Gosling, an associate professor at Paris Nanterre University and the study’s first lead author, told The Epoch Times in an email. “We really hope that the platform could empower people.”

What Research Shows

Specifically, the review found drug interventions offer the largest benefits, particularly for children, though they can be poorly tolerated. The findings mirror current treatment guidelines that prioritize cognitive behavioral therapy, parent-mediated behavioral interventions, and medication.

Children and Teens (Ages 6 to 17)

Five drug types showed medium to large effects in reducing the severity of ADHD symptoms in children and teens—alpha-2 agonists, amphetamines, atomoxetine, methylphenidate, and viloxazine. Methylphenidate and amphetamines are stimulant drugs, and they showed the most benefit, though patients in the studies reported some issues with tolerance, lack of appetite, and trouble sleeping.

Nondrug interventions, including cognitive behavioral therapy, acupuncture, parent-mediated behavioral training, physical exercise, and neurofeedback, which reprograms the brain to enable focus or relaxation, also helped with symptoms, though the evidence was of lower quality.

Diet was also found to help with symptoms, though it was not well tolerated, and the evidence was weaker.

Preschool Children

Studies for interventions in preschool children focused only on methylphenidate or parent-mediated behavioral training, both of which were found to be effective for symptoms. Methylphenidate was sometimes discontinued due to adverse events.

Adults

There was a medium effect in reducing the severity of ADHD symptoms in adults taking atomoxetine, a nonstimulant drug, and methylphenidate, and using cognitive behavioral therapy. High-quality trials also showed an effect for amphetamines.

For nondrug interventions, mindfulness had a high effect with low-quality evidence. Transcranial direct current stimulation, which is noninvasive weak electrical brain stimulation, and neurofeedback also showed some effect.

The review and the website report improvements in the main ADHD symptoms as rated by clinician, teacher, parent, self, or mixed. Besides showing whether an intervention is promising, the website also notes whether the evidence behind each intervention is high, moderate, low, or very low.

Exposing Research Gaps

The website reveals gaps in the evidence, particularly for nondrug interventions.

“This reflects the current state of the scientific literature, where nonpharmacological interventions often face methodological challenges,” Gosling said, noting that studies of nondrug treatments often don’t involve randomized controlled trials.

He said he hopes the transparency will encourage researchers to conduct higher-quality trials in nondrug interventions. None of the nondrug interventions included in the review reached high or moderate certainty evidence, though acupuncture and cognitive behavioral therapy showed statistically significant effects.

Weighing Options

The question of whether to medicate for ADHD—including what drugs to use, when to start, and how to monitor adverse effects—is one that plagues many patients and their families.

Patients may want to consider cognitive behavioral therapy before drugs, Dr. Gail Saltz, clinical associate professor of psychiatry at Weill Cornell Medical College, who was not part of the study, told The Epoch Times.

Many deficiencies can be addressed with workarounds developed in therapy, including creating systems that help children learn to read and follow instructions, remind them of essential tasks, and keep paperwork and other essentials organized, said Saltz.

She noted that medication may be appropriate when symptoms seriously disrupt daily functioning and self-esteem, but only after a thorough evaluation and with careful consideration of potential side effects. “Medication has to be done really thoughtfully,” Saltz said. “For a lot of people, it seems just expeditious, but it’s a Band-Aid,” she added. “It only helps while you’re on the medication, as opposed to the behavioral interventions, which are lasting.”

However, the review authors noted that ADHD drugs offer benefits beyond symptom reduction, such as reducing the risk of death from unnatural causes and lowering suicidal behavior, unintentional injuries, substance misuse, car accidents, and criminality, as well as improving school success.

“Currently, we are not aware of any observational evidence of this kind for non-drug interventions, but this should be pursued in future research,” they wrote.

Future Enhancements

The review authors plan to keep updating the website as research evolves so that it will remain relevant. They are already working on expanding the adverse effects section beyond sleep and appetite. They were included in the review because they are the most consistently reported in randomized controlled trials, Gosling said, and also because a patient panel identified them as most affecting quality of life.

Website users can also use tolerability rankings—meaning patients stopped treatment due to adverse events—as an indication of whether patients struggled with an intervention, he added.

By the end of next year, there may be more adverse effects added to the platform, Gosling said.

“We are developing a decision-aid tool that will allow users to rank which side effects they most wish to avoid, helping to match them with the most suitable treatment options.”