Effectiveness and safety of antidepressants for ADHD in population between 6 and 19 years: a systematic review

Introduction: Attention deficit hyperactivity disorder (ADHD) is generally treated with pharmacologic and non-pharmacologic interventions. Pharmacological treatment is necessary for most patients. Antidepressants are an option so it is important to know about their effectiveness and safety. Purpose: To identify, synthesize and evaluate the best available evidence on the effectiveness and safety of antidepressants in the treatment of ADHD in the 6-19 year-old population. Methods: A systematic review of intervention studies that evaluated effectiveness comparing antidepressants to methylphenidate was conducted. Outcomes assessed were educational performance, psychosocial functioning, quality of life and adverse effects. We searched the following databases up to February 2012 in English and Spanish: PubMed/MEDLINE, LILACS, Cochrane, DARE and National Guideline Clearinghouse. The articles that met inclusion criteria were assessed by two researchers independently. Results: Of the 37 studies found initially, three were included, a systematic review and two clinical guidelines. Conclusions: The available evidence on the use of antidepressants in ADHD suggests that they are not first choice; their indication is subject to comorbidities and context. Further good-quality studies are needed.