Effect ot Continuing and Discontinuing Medications on Quality of Life after Symptomatic Remission in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Abstract

Objective.-This study aimed to compare the effect of continuing and discontinuing medications on quality of life d patents with attention-deficit/hyperactivity disorder (ADHD). Data Sources: PubMed, Cochrane Library, and Embase databases were searched using generic terms for ADHD, discontinuing, continuing, pharmacotherapy, and randomized ccntrd led trials without date or tang uage restrictions. Study Selection: Of the 3,672 screened studies, 9 met the predefined inclusion criteria on patients with ADHD; 5 of these 9 stud >65 reporting on 1,463 patients (ch ildren and adolescents, n = 894; adults, n= 569) measured quality of life and were included in this meta-analysis. Only randomized, double-blind, placebo-controlled withdrawal trials d ADHD nvdkatiorewere induced. Data Extraction: Data were independently extracted according to the Cochrane Handbook for Systematic fteviews of Interventions. Analyses were based cn random-effects models. Results: Com pared with conti nuing med ications, discontinuing them significantly worsened quality of life score in patients with ADHD (standa rdized mean difference [SMD]= 0.19; 95% CI, 0.08 to 0i30]). Moreover, discontinu ing medications worsened this score in children and addescents with ADHD (SMO=02 1; 95% CI, 0jQ6 to 036) but not in adults with ADHD (SVO=0.02; 95% CI,-0.46 to 0.50). Conclusions: Discontinuing rrwdkatiore was associated with a small but statistically significant decrease in quality of life among children and addescents with ADHD but not in adults with ADHD. Qual ity of life can be applied in pharmacologic interventions regarding continuing and discontinuing medication because this concept is related to individuals'appraisal d their situation. Quality d life is an important factor for planning individualized ADH D medication treatment.