Dose-response relationship of extended-release methylphenidate for ADHD in adults: post-hoc analysis based on a systematic review

Objective To assess potential dose-response relationships of extended-release methylphenidate for ADHD in adults on efficacy outcomes. Study design and setting Post-hoc analysis based on a systematic review of extended-release methylphenidate ( https://doi.org/10.1002/14651858.CD012857 ). Using data from clinical trials comparing multiple fixed-dose methylphenidate groups with placebo, we conducted subgroup meta-analyses for available efficacy outcomes. Results and conclusion Five trials used a fixed-dose design with multiple methylphenidate groups receiving different doses. All trials were pivotal industry sponsored studies conducted to obtain marketing authorisation. We analysed four efficacy outcomes: Selfrated ADHD symptoms (5 trials, 1807 participants), investigator-rated ADHD symptoms (5 trials, 1904 participants), quality of life (4 trials, 1158 participants), and peer-rated ADHD symptoms (2 trials, 879 participants). There were no dose-response relationships for any outcome.