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Can response to ADHD medication be predicted?

Lilja, Maria M. ; Lichtenstein, Paul ; Serlachius, Eva LU ; Bhagia, Jyoti ; Malmberg, Kerstin ; Malm, Christer ; Lenhard, Fabian and Halldner, Linda (2025) In European Child and Adolescent Psychiatry
Abstract

Predictors for the pharmacological effect of ADHD medication in children and adolescents are lacking. This study examined clinically relevant factors in a large (N = 638) prospective cohort reflecting real-world evidence. Children and adolescents aged 6–17 diagnosed with ADHD were evaluated at baseline and three months following ADHD medication initiation. The outcome was measured as a reduction in total SNAP-IV (Swanson Nolan and Pelham teacher and parent rating scale) score at three months compared to baseline. Outcome groups were defined as Responders (≥ 40% reduction), Intermediate Responders (≥ 20 to < 40% reduction), and Non-responders (< 20% reduction). Included independent variables were the Autism Spectrum Questionnaire... (More)

Predictors for the pharmacological effect of ADHD medication in children and adolescents are lacking. This study examined clinically relevant factors in a large (N = 638) prospective cohort reflecting real-world evidence. Children and adolescents aged 6–17 diagnosed with ADHD were evaluated at baseline and three months following ADHD medication initiation. The outcome was measured as a reduction in total SNAP-IV (Swanson Nolan and Pelham teacher and parent rating scale) score at three months compared to baseline. Outcome groups were defined as Responders (≥ 40% reduction), Intermediate Responders (≥ 20 to < 40% reduction), and Non-responders (< 20% reduction). Included independent variables were the Autism Spectrum Questionnaire (ASSQ), the Spence Children’s Anxiety Scale (SCAS), the Pediatric Side Effect Checklist (P-SEC), anthropometrics measures, geographical region, relative age, Children´s Global Assessment Scale (CGAS), Intelligence quotient (IQ), pharmacological treatment initiation month, ADHD symptom severity, ADHD presentation, and psychotic-like experiences. Multinomial logistic regression suggested that ADHD symptom severity, region, relative age, and stating ADHD medication at three-month follow-up were associated with the response outcome group. However, when validating the data with Bootstrap Forest, none of the variables were significant. Thus, in our large naturalistic cohort, we could not identify any clinically relevant factors that reliably predict pharmacological treatment outcomes. Trial registration: NCT02136147.

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author
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
ADHD, Effect, Pharmacological treatment, Predictors, Response
in
European Child and Adolescent Psychiatry
article number
e0180355
publisher
Springer
external identifiers
  • pmid:39875602
  • scopus:85217181709
ISSN
1018-8827
DOI
10.1007/s00787-025-02650-8
language
English
LU publication?
yes
id
272a9558-63ee-4ea1-9051-e99c715b84ff
date added to LUP
2025-06-02 08:53:52
date last changed
2025-07-14 12:34:41
@article{272a9558-63ee-4ea1-9051-e99c715b84ff,
  abstract     = {{<p>Predictors for the pharmacological effect of ADHD medication in children and adolescents are lacking. This study examined clinically relevant factors in a large (N = 638) prospective cohort reflecting real-world evidence. Children and adolescents aged 6–17 diagnosed with ADHD were evaluated at baseline and three months following ADHD medication initiation. The outcome was measured as a reduction in total SNAP-IV (Swanson Nolan and Pelham teacher and parent rating scale) score at three months compared to baseline. Outcome groups were defined as Responders (≥ 40% reduction), Intermediate Responders (≥ 20 to &lt; 40% reduction), and Non-responders (&lt; 20% reduction). Included independent variables were the Autism Spectrum Questionnaire (ASSQ), the Spence Children’s Anxiety Scale (SCAS), the Pediatric Side Effect Checklist (P-SEC), anthropometrics measures, geographical region, relative age, Children´s Global Assessment Scale (CGAS), Intelligence quotient (IQ), pharmacological treatment initiation month, ADHD symptom severity, ADHD presentation, and psychotic-like experiences. Multinomial logistic regression suggested that ADHD symptom severity, region, relative age, and stating ADHD medication at three-month follow-up were associated with the response outcome group. However, when validating the data with Bootstrap Forest, none of the variables were significant. Thus, in our large naturalistic cohort, we could not identify any clinically relevant factors that reliably predict pharmacological treatment outcomes. Trial registration: NCT02136147.</p>}},
  author       = {{Lilja, Maria M. and Lichtenstein, Paul and Serlachius, Eva and Bhagia, Jyoti and Malmberg, Kerstin and Malm, Christer and Lenhard, Fabian and Halldner, Linda}},
  issn         = {{1018-8827}},
  keywords     = {{ADHD; Effect; Pharmacological treatment; Predictors; Response}},
  language     = {{eng}},
  publisher    = {{Springer}},
  series       = {{European Child and Adolescent Psychiatry}},
  title        = {{Can response to ADHD medication be predicted?}},
  url          = {{http://dx.doi.org/10.1007/s00787-025-02650-8}},
  doi          = {{10.1007/s00787-025-02650-8}},
  year         = {{2025}},
}