The female side of pharmacotherapy for ADHD-A systematic literature review

PLoS One. 2020 Sep 18;15(9):e0239257. doi: 10.1371/journal.pone.0239257. eCollection 2020.

Abstract

Objective: This comprehensive review examined sex differences in prescription rates and efficacy or effectiveness of pharmacotherapy treatment in girls and women with attention deficit hyperactivity disorder (ADHD), while identifying gaps in the scientific knowledge on this topic.

Method: A rigorous electronic database search was carried out in order to identify all published studies on female-specific effects of stimulants and non-stimulants in the treatment of ADHD. In total, 2672 studies were screened of which 21 studies (seven on prescription rates, 14 on effects of pharmacotherapy) met the inclusion criteria and were included for analysis.

Results: In all seven studies on ADHD prescription rates, girls received significantly less prescriptions than boys, a difference however no longer seen in adults with the exception of one study. Each of the 14 studies on effectiveness / efficacy found at least one sex-difference in the effects of ADHD pharmacotherapy.

Conclusion: Several sex-differences are demonstrated in the prescription, usage and efficacy /effectiveness of both stimulant and non-stimulant ADHD pharmacotherapy. A single daily use of MPH may possibly not be optimal for girls with ADHD and ATX may be a promising medication for girls and women with ADHD. The robustness of this result requires further investigation.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Atomoxetine Hydrochloride / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / pathology
  • Central Nervous System Stimulants / therapeutic use
  • Child
  • Child, Preschool
  • Databases, Factual
  • Drug Prescriptions / standards
  • Female
  • Humans
  • Male
  • Men
  • Methylphenidate / therapeutic use
  • Sex Characteristics*
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride

Grants and funding

The author(s) received no specific funding for this work.