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The Impact of Medications on Quality of Life in Attention-Deficit Hyperactivity Disorder

A Systematic Review

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Abstract

Quality of life (QOL) describes an individual’s subjective perception of their position in life as evidenced by their physical, psychological and social functioning. Although an established outcome measure in physical health, QOL has more recently become an increasingly important measure in mental health clinical work and research. This article reviews the evidence describing the impact of medications on QOL in attention-deficit hyperactivity disorder (ADHD). Databases were searched for research studies describing the effects of medication on QOL in ADHD: 25 relevant studies were identified. Most (n = 20) of these studies have focused on children and adolescents, and most have investigated a single molecule, atomoxetine (n=15), with relatively few studies investigating methylphenidate (n=5), amfetamines (n = 4) and manifaxine (n= 1).

These studies support a positive short-term effect of medication on QOL in ADHD for children, adolescents and adults that mirrors, to some extent, the effects of these medications on ADHD symptoms, although with smaller effect sizes. Notwithstanding measurement issues, it will continue to be important that those designing and conducting clinical trials in ADHD, including both pharmacological and non-pharmacological treatments, continue to include measures of QOL as secondary outcome measures. In particular, information about QOL effects in adults and in subjects of all ages taking methylphenidate and amfetamine treatments is urgently needed. The lack of systematic studies of the impact on QOL of psychological therapies, either on their own or in multimodal combinations with medication, is a serious omission that should be urgently addressed.

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Notes

  1. The authors reported a significant improvement in parent-rated DUX-25 total score for children taking medication; however, inspection of the reported scores suggests poorer parent-rated QOL taking medication.

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Acknowledgements

No sources of funding were used to prepare this review. Dr Coghill’s department has had research support from Eli Lilly, Janssen Cilag and Shire. He has served in an advisory or consultancy role for Eli Lilly, Janssen Cilag, Pfizer, Shire, Flynn, Schering-Plough and UCB. He has received conference attendance support or was paid for public speaking by Eli Lilly, Janssen McNeil, UCB, Shire and Flynn.

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    David Coghill

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Coghill, D. The Impact of Medications on Quality of Life in Attention-Deficit Hyperactivity Disorder. CNS Drugs 24, 843–866 (2010). https://doi.org/10.2165/11537450-000000000-00000

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