# The evidence map

Published by Pawel Jozefiak. [About this project](https://adhd100.jock.pl/about/), [How we check sources](https://adhd100.jock.pl/methodology/)

- Canonical: https://adhd100.jock.pl/evidence/
- Language: en
- First published: 2026-09-29
- Evidence checked: 2026-09-29, using AI-assisted source verification

Every ADHD treatment that has been pooled across trials: 221 meta-analyses, one row each. The dot is the effect, the bar is the 95% confidence interval, the moon is how sure the evidence is. Almost everything covers about 12 weeks.

The pattern is the point: few things have strong evidence, many popular things have weak evidence, and nothing has strong long-term evidence.

## How to read it

Most rows are a standardised mean difference (SMD): how far the treated group moved compared with the control, in standard deviations. 0 is no difference. Around 0.2 is small, 0.5 medium, 0.8 large. Positive favours the treatment. The dot is the estimate, the line its 95% confidence interval: if the line crosses 0, the trials cannot rule out no effect.

Acceptability and tolerability rows are a risk ratio (RR), drawn on a log scale, where 1 means no difference. The direction is as reported by the review.

The moon is GRADE certainty as rated by the review authors. A full moon means more trials are unlikely to change the number; a crescent means they very well might. Nothing is hidden by a filter; the scale never changes between rows, so a long bar is a wide interval, not a zoom.

## All 221 comparisons

| Intervention | Age group | Outcome | Rated by | Follow up | Effect (95% CI) | Certainty | Trials, people | On the list |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Acupuncture | children and teens | Conduct disorder symptoms (CD) | parent rated | about 12 weeks | SMD 0.66 (0.36 to 0.97) | Very low certainty | 2 trials, 171 people |  |
| Acupuncture | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.79 (0.48 to 1.1) | Very low certainty | 2 trials, 171 people |  |
| Acupuncture | children and teens | Generalized anxiety | parent rated | about 12 weeks | SMD 0.04 (-0.26 to 0.34) | Low certainty | 2 trials, 171 people |  |
| Acupuncture | children and teens | Learning disorder symptoms | parent rated | about 12 weeks | SMD 0.63 (0.32 to 0.93) | Very low certainty | 2 trials, 171 people |  |
| Alpha-2 agonists (guanfacine / clonidine) | adults | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.66 (0.38 to 0.94) | Very low certainty | 2 trials, 235 people |  |
| Alpha-2 agonists (guanfacine / clonidine) | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.37 (1.05 to 1.78) | Low certainty | 11 trials, 1456 people |  |
| Alpha-2 agonists (guanfacine / clonidine) | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.3 (0.17 to 0.53) | Very low certainty | 6 trials, 1704 people |  |
| Alpha-2 agonists (guanfacine / clonidine) | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.64 (0.48 to 0.79) | High certainty | 8 trials, 1497 people | [Ask about alpha-2 nonstimulant options](https://adhd100.jock.pl/discuss-alpha2-child/) |
| Alpha-2 agonists (guanfacine / clonidine) | children and teens | Tics/Tourette disorder symptoms | not split by rater | about 12 weeks | SMD 0.77 (0.52 to 1.02) | Low certainty | 4 trials, 297 people |  |
| Alpha-2 agonists (guanfacine / clonidine) | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.28 (0.13 to 0.63) | Very low certainty | 8 trials, 1287 people |  |
| Amphetamines | adults | Acceptability | not split by rater | about 12 weeks | RR 1.19 (0.95 to 1.49) | Moderate certainty | 10 trials, 1957 people |  |
| Amphetamines | adults | CGI | not split by rater | about 12 weeks | SMD 0.85 (0.59 to 1.11) | Very low certainty | 3 trials, 341 people |  |
| Amphetamines | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.53 (0.3 to 0.77) | Low certainty | 4 trials, 300 people |  |
| Amphetamines | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.63 (0.4 to 0.87) | Low certainty | 9 trials, 1857 people |  |
| Amphetamines | adults | Depressive disorder symptoms | clinician rated | about 12 weeks | SMD -0.16 (-0.52 to 0.21) | Very low certainty | 2 trials, 110 people |  |
| Amphetamines | adults | Emotional dysregulation | not split by rater | about 12 weeks | SMD 0.34 (0.12 to 0.57) | Very low certainty | 3 trials, 235 people |  |
| Amphetamines | adults | Exec. functions (report) | not split by rater | about 12 weeks | SMD 0.66 (0.51 to 0.8) | Very low certainty | 4 trials, 722 people |  |
| Amphetamines | adults | Generalized anxiety | clinician rated | about 12 weeks | SMD -0.13 (-0.49 to 0.24) | Very low certainty | 2 trials, 110 people |  |
| Amphetamines | adults | Quality of life | self rated | about 12 weeks | SMD 0.52 (0.33 to 0.72) | Very low certainty | 2 trials, 429 people |  |
| Amphetamines | adults | Tolerability | not split by rater | about 12 weeks | RR 0.4 (0.22 to 0.72) | High certainty | 11 trials, 1995 people |  |
| Amphetamines | children and teens | Academic/job performance | not split by rater | about 12 weeks | SMD 0.55 (0.37 to 0.73) | Moderate certainty | 8 trials, 826 people |  |
| Amphetamines | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.23 (0.86 to 1.76) | Moderate certainty | 7 trials, 1343 people |  |
| Amphetamines | children and teens | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.19 (0.1 to 0.33) | Low certainty | 11 trials, 2467 people |  |
| Amphetamines | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.28 (0.17 to 0.46) | Low certainty | 10 trials, 2429 people |  |
| Amphetamines | children and teens | CGI | not split by rater | about 12 weeks | SMD 0.87 (0.01 to 1.73) | Very low certainty | 2 trials, 86 people |  |
| Amphetamines | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 1.02 (0.67 to 1.38) | Moderate certainty | 5 trials, 876 people | [Ask about amphetamine alternatives](https://adhd100.jock.pl/discuss-amphetamines-child/) |
| Amphetamines | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.57 (0.28 to 0.86) | Low certainty | 7 trials, 1247 people |  |
| Amphetamines | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.55 (0.27 to 0.83) | Very low certainty | 5 trials, 745 people |  |
| Amphetamines | children and teens | Disruptive behaviors | not split by rater | about 12 weeks | SMD 1.05 (0.65 to 1.45) | Very low certainty | 3 trials, 130 people |  |
| Amphetamines | children and teens | Quality of life | self rated | about 12 weeks | SMD 0.48 (-0.52 to 1.47) | Very low certainty | 2 trials, 521 people |  |
| Amphetamines | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.46 (0.22 to 0.96) | Moderate certainty | 7 trials, 1343 people |  |
| Atomoxetine | adults | Acceptability | not split by rater | about 12 weeks | RR 0.82 (0.74 to 0.9) | Moderate certainty | 14 trials, 3292 people |  |
| Atomoxetine | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.37 (0.27 to 0.47) | High certainty | 7 trials, 1734 people | [Ask about atomoxetine as an adult](https://adhd100.jock.pl/discuss-atomoxetine-adult/) |
| Atomoxetine | adults | Core ADHD symptoms | clinician rated | 3 to 6 months | SMD 0.33 (0.08 to 0.59) | Very low certainty | 3 trials, 1006 people |  |
| Atomoxetine | adults | Core ADHD symptoms | self rated | 3 to 6 months | SMD 0.35 (0.22 to 0.49) | Very low certainty | 2 trials, 872 people |  |
| Atomoxetine | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.55 (0.33 to 0.76) | Very low certainty | 11 trials, 2537 people |  |
| Atomoxetine | adults | Emotional dysregulation | not split by rater | about 12 weeks | SMD 0.24 (0.14 to 0.35) | High certainty | 5 trials, 2373 people |  |
| Atomoxetine | adults | Exec. functions (report) | not split by rater | about 12 weeks | SMD 0.38 (0.21 to 0.55) | Very low certainty | 2 trials, 535 people |  |
| Atomoxetine | adults | Quality of life | not split by rater | about 12 weeks | SMD -0.22 (-0.38 to -0.07) | Very low certainty | 2 trials, 651 people |  |
| Atomoxetine | adults | Tolerability | not split by rater | about 12 weeks | RR 0.45 (0.35 to 0.58) | High certainty | 14 trials, 3292 people |  |
| Atomoxetine | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1 (0.77 to 1.3) | High certainty | 13 trials, 1831 people |  |
| Atomoxetine | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.53 (0.42 to 0.64) | Moderate certainty | 17 trials, 2467 people |  |
| Atomoxetine | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.4 (0.03 to 0.77) | Very low certainty | 8 trials, 1218 people |  |
| Atomoxetine | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.45 (-0.06 to 0.95) | Very low certainty | 2 trials, 119 people |  |
| Atomoxetine | children and teens | Depressive disorder symptoms | not split by rater | about 12 weeks | SMD 0.15 (-0.04 to 0.35) | Very low certainty | 4 trials, 774 people |  |
| Atomoxetine | children and teens | Generalized anxiety | not split by rater | about 12 weeks | SMD 0.17 (-0.13 to 0.47) | Low certainty | 3 trials, 498 people |  |
| Atomoxetine | children and teens | Quality of life | not split by rater | about 12 weeks | SMD 0.33 (0.19 to 0.48) | Moderate certainty | 6 trials, 1179 people |  |
| Atomoxetine | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.54 (0.27 to 1.08) | High certainty | 12 trials, 1799 people |  |
| Bupropion | adults | Acceptability | not split by rater | about 12 weeks | RR 0.97 (0.21 to 4.45) | Very low certainty | 2 trials, 99 people |  |
| Bupropion | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.39 (0.08 to 0.69) | Very low certainty | 2 trials, 202 people |  |
| Bupropion | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.8 (0.25 to 1.35) | Very low certainty | 2 trials, 64 people |  |
| Bupropion | adults | Depressive disorder symptoms | not split by rater | about 12 weeks | SMD -0.16 (-0.45 to 0.13) | Low certainty | 2 trials, 184 people |  |
| Bupropion | adults | Generalized anxiety | not split by rater | about 12 weeks | SMD -0.11 (-0.39 to 0.18) | Low certainty | 2 trials, 184 people |  |
| Bupropion | adults | Tolerability | not split by rater | about 12 weeks | RR 1.26 (0.08 to 19.59) | Very low certainty | 2 trials, 99 people |  |
| Bupropion | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.68 (0.19 to 2.52) | Very low certainty | 2 trials, 139 people |  |
| Bupropion | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.31 (-0.05 to 0.68) | Very low certainty | 2 trials, 124 people |  |
| Bupropion | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.35 (0.04 to 2.95) | Very low certainty | 2 trials, 139 people |  |
| Carnitine | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.24 (0.76 to 2.02) | Very low certainty | 4 trials, 247 people |  |
| Centafanadine | adults | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.43 (0.08 to 0.79) | Very low certainty | 2 trials, 444 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Acceptability | not split by rater | about 12 weeks | RR 1.11 (0.75 to 1.64) | Low certainty | 10 trials, 867 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | CGI | clinician rated | about 12 weeks | SMD 1.15 (0.31 to 1.98) | Very low certainty | 5 trials, 260 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.53 (0.29 to 0.77) | Moderate certainty | 5 trials, 265 people | [Ask about CBT adapted for adult ADHD](https://adhd100.jock.pl/seek-adult-adhd-cbt/) |
| Cognitive Behavioral Therapy (CBT) | adults | Core ADHD symptoms | clinician rated | 3 to 6 months | SMD 0.31 (-0.06 to 0.68) | Very low certainty | 2 trials, 109 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.37 (0.15 to 0.58) | Very low certainty | 9 trials, 607 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Core ADHD symptoms | self rated | 3 to 6 months | SMD 0.56 (0.3 to 0.83) | Very low certainty | 5 trials, 413 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Core ADHD symptoms | self rated | over 6 months | SMD 0.6 (-0.09 to 1.29) | Very low certainty | 2 trials, 109 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Depressive disorder symptoms | self rated | about 12 weeks | SMD 0.45 (0.14 to 0.77) | Very low certainty | 5 trials, 187 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Generalized anxiety | self rated | about 12 weeks | SMD 0.35 (0.05 to 0.64) | Very low certainty | 4 trials, 168 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Quality of life | not split by rater | about 12 weeks | SMD 0.26 (-0.18 to 0.7) | Very low certainty | 2 trials, 77 people |  |
| Cognitive Behavioral Therapy (CBT) | adults | Tolerability | not split by rater | about 12 weeks | RR 1.07 (0.11 to 10.07) | Very low certainty | 3 trials, 184 people |  |
| Cognitive Behavioral Therapy (CBT) | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.7 (0.39 to 1) | Very low certainty | 3 trials, 167 people |  |
| Cognitive training | adults | Acceptability | not split by rater | about 12 weeks | RR 1.3 (0.64 to 2.62) | Very low certainty | 3 trials, 189 people |  |
| Cognitive training | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD -0.01 (-0.33 to 0.31) | Very low certainty | 4 trials, 160 people |  |
| Cognitive training | adults | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.41 (-0.18 to 1) | Very low certainty | 4 trials, 141 people |  |
| Cognitive training | adults | Quality of life | not split by rater | about 12 weeks | SMD -0.31 (-0.83 to 0.21) | Very low certainty | 2 trials, 58 people |  |
| Cognitive training | children and teens | Academic/job performance | not split by rater | about 12 weeks | SMD 0.2 (-0.04 to 0.44) | Very low certainty | 4 trials, 237 people |  |
| Cognitive training | children and teens | Academic/job performance | not split by rater | 3 to 6 months | SMD 0.26 (-0.08 to 0.59) | Very low certainty | 4 trials, 180 people |  |
| Cognitive training | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.61 (0.37 to 1.01) | Very low certainty | 8 trials, 535 people |  |
| Cognitive training | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.11 (-0.04 to 0.27) | Low certainty | 7 trials, 395 people |  |
| Cognitive training | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.12 (-0.17 to 0.4) | Very low certainty | 2 trials, 111 people |  |
| Cognitive training | children and teens | Core ADHD symptoms | parent rated | 3 to 6 months | SMD 0.13 (-0.15 to 0.42) | Very low certainty | 5 trials, 273 people |  |
| Cognitive training | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.2 (-0.04 to 0.43) | Very low certainty | 10 trials, 533 people |  |
| Cognitive training | children and teens | Exec. functions (report) | not split by rater | about 12 weeks | SMD 0.09 (-0.18 to 0.36) | Very low certainty | 3 trials, 195 people |  |
| Cognitive training | children and teens | Exec. functions (report) | parent rated | about 12 weeks | SMD 0.1 (-0.16 to 0.36) | Very low certainty | 5 trials, 238 people |  |
| Cognitive training | children and teens | Exec. functions (report) | not split by rater | 3 to 6 months | SMD 0.16 (-0.12 to 0.43) | Very low certainty | 3 trials, 195 people |  |
| Cognitive training | children and teens | Exec. functions (report) | parent rated | 3 to 6 months | SMD 0.44 (0.02 to 0.87) | Very low certainty | 2 trials, 82 people |  |
| Cognitive training | children and teens | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.2 (0.06 to 0.34) | Low certainty | 11 trials, 623 people |  |
| Cognitive training | children and teens | Exec. functions (tests) | not split by rater | 3 to 6 months | SMD 0.2 (0.01 to 0.38) | Very low certainty | 6 trials, 374 people |  |
| Dasotraline | adults | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.26 (0.12 to 0.53) | Very low certainty | 2 trials, 492 people |  |
| Dasotraline | adults | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.33 (0.22 to 0.5) | Very low certainty | 2 trials, 492 people |  |
| Dasotraline | adults | CGI | not split by rater | about 12 weeks | SMD 0.23 (0 to 0.47) | Very low certainty | 2 trials, 482 people |  |
| Dasotraline | adults | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.19 (0.01 to 0.37) | Very low certainty | 2 trials, 482 people |  |
| Dasotraline | children and teens | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.31 (0.13 to 0.73) | Very low certainty | 3 trials, 380 people |  |
| Dasotraline | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.22 (0.09 to 0.51) | Very low certainty | 3 trials, 380 people |  |
| Dasotraline | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.63 (0.2 to 1.06) | Very low certainty | 3 trials, 378 people |  |
| Desipramine | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.22 (0.3 to 4.99) | Very low certainty | 2 trials, 114 people |  |
| Desipramine | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.98 (0.28 to 1.67) | Very low certainty | 2 trials, 89 people |  |
| Desipramine | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 1.43 (0.86 to 2) | Very low certainty | 2 trials, 99 people |  |
| Desipramine | children and teens | Tolerability | not split by rater | about 12 weeks | RR 1.42 (0.1 to 20.48) | Very low certainty | 2 trials, 114 people |  |
| Dialectical Behavioral Therapy (DBT) | adults | Acceptability | not split by rater | about 12 weeks | RR 0.9 (0.55 to 1.47) | Low certainty | 3 trials, 368 people |  |
| Dialectical Behavioral Therapy (DBT) | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.22 (-0.32 to 0.77) | Low certainty | 3 trials, 286 people |  |
| Diet (restricted/elimination) | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.94 (0.55 to 1.62) | Very low certainty | 4 trials, 273 people |  |
| Diet (restricted/elimination) | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.73 (-0.06 to 1.52) | Very low certainty | 4 trials, 218 people |  |
| Diet (restricted/elimination) | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.37 (0.04 to 3.43) | Very low certainty | 2 trials, 127 people |  |
| Homeopathy | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.45 (0.73 to 2.87) | Very low certainty | 2 trials, 104 people |  |
| Homeopathy | children and teens | CD/ODD symptoms | parent rated | about 12 weeks | SMD 0.02 (-0.44 to 0.48) | Very low certainty | 2 trials, 63 people |  |
| Homeopathy | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD -0.05 (-0.51 to 0.41) | Very low certainty | 2 trials, 63 people |  |
| Methylphenidate | adults | Acceptability | not split by rater | about 12 weeks | RR 1 (0.82 to 1.22) | Very low certainty | 20 trials, 3925 people |  |
| Methylphenidate | adults | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.25 (0.2 to 0.3) | Very low certainty | 16 trials, 4491 people |  |
| Methylphenidate | adults | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.51 (0.39 to 0.67) | Very low certainty | 16 trials, 4435 people |  |
| Methylphenidate | adults | CGI | clinician rated | about 12 weeks | SMD 0.7 (-0.13 to 1.53) | Very low certainty | 2 trials, 139 people |  |
| Methylphenidate | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.34 (0.26 to 0.43) | High certainty | 13 trials, 2944 people | [Discuss methylphenidate as an adult](https://adhd100.jock.pl/discuss-methylphenidate-adult/) |
| Methylphenidate | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.5 (0.39 to 0.61) | Moderate certainty | 18 trials, 3680 people |  |
| Methylphenidate | adults | Core ADHD symptoms | self rated | 3 to 6 months | SMD 0.26 (0.07 to 0.44) | Very low certainty | 2 trials, 498 people |  |
| Methylphenidate | adults | Core ADHD symptoms | clinician rated | 3 to 6 months | SMD 0.34 (0.16 to 0.52) | Very low certainty | 2 trials, 506 people |  |
| Methylphenidate | adults | Driving | clinician rated | about 12 weeks | SMD 0.53 (-0.07 to 1.13) | Very low certainty | 3 trials, 154 people | [Discuss treatment and driving safety](https://adhd100.jock.pl/review-medication-driving-safety/) |
| Methylphenidate | adults | Emotional dysregulation | not split by rater | about 12 weeks | SMD 0.43 (-0.01 to 0.88) | Very low certainty | 3 trials, 655 people |  |
| Methylphenidate | adults | Exec. functions (report) | self rated | about 12 weeks | SMD 0.65 (-0.02 to 1.32) | Very low certainty | 5 trials, 1579 people |  |
| Methylphenidate | adults | Exec. functions (tests) | clinician rated | about 12 weeks | SMD 0.15 (0.03 to 0.28) | Moderate certainty | 15 trials, 973 people |  |
| Methylphenidate | adults | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.15 (-0.3 to 0.6) | Very low certainty | 2 trials, 71 people |  |
| Methylphenidate | adults | Quality of life | not split by rater | about 12 weeks | SMD -0.09 (-0.28 to 0.1) | Low certainty | 2 trials, 490 people |  |
| Methylphenidate | adults | Tolerability | not split by rater | about 12 weeks | RR 0.5 (0.36 to 0.69) | High certainty | 21 trials, 4389 people |  |
| Methylphenidate | under 6 | Acceptability | not split by rater | about 12 weeks | RR 2.89 (1.55 to 5.38) | Very low certainty | 2 trials, 216 people |  |
| Methylphenidate | under 6 | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.63 (0.28 to 0.97) | Very low certainty | 5 trials, 623 people |  |
| Methylphenidate | under 6 | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.66 (0.22 to 1.11) | Very low certainty | 5 trials, 526 people |  |
| Methylphenidate | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.58 (1.35 to 1.85) | High certainty | 21 trials, 2947 people |  |
| Methylphenidate | children and teens | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.26 (0.19 to 0.36) | Low certainty | 41 trials, 6091 people |  |
| Methylphenidate | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.53 (0.4 to 0.72) | Very low certainty | 37 trials, 5499 people |  |
| Methylphenidate | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.76 (0.56 to 0.97) | High certainty | 6 trials, 1038 people | [Discuss methylphenidate for your child](https://adhd100.jock.pl/discuss-methylphenidate-child/) |
| Methylphenidate | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.79 (0.63 to 0.94) | High certainty | 8 trials, 852 people |  |
| Methylphenidate | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.83 (0.63 to 1.03) | Moderate certainty | 5 trials, 437 people |  |
| Methylphenidate | children and teens | Core ADHD symptoms | parent rated | 3 to 6 months | SMD 0.57 (0.35 to 0.79) | Very low certainty | 2 trials, 322 people |  |
| Methylphenidate | children and teens | Generalized anxiety | not split by rater | about 12 weeks | SMD 0.38 (-0.21 to 0.98) | Very low certainty | 3 trials, 162 people |  |
| Methylphenidate | children and teens | Quality of life | not split by rater | about 12 weeks | SMD 0.61 (0.42 to 0.8) | Low certainty | 3 trials, 514 people |  |
| Methylphenidate | children and teens | Suicidal ideation/behavior | not split by rater | about 12 weeks | RR 1.1 (0.25 to 4.96) | Moderate certainty | 6 trials, 1032 people |  |
| Methylphenidate | children and teens | Tics/Tourette disorder symptoms | not split by rater | about 12 weeks | SMD 0.12 (-0.39 to 0.62) | Low certainty | 3 trials, 217 people |  |
| Methylphenidate | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.64 (0.36 to 1.12) | High certainty | 20 trials, 2878 people |  |
| Methylphenidate + Alpha-2 agonists | children and teens | Acceptability | not split by rater | about 12 weeks | RR 2.42 (1.38 to 4.25) | Very low certainty | 2 trials, 127 people |  |
| Methylphenidate + Alpha-2 agonists | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.35 (0.04 to 3.27) | Very low certainty | 2 trials, 127 people |  |
| Mindfulness | adults | Acceptability | not split by rater | about 12 weeks | RR 0.24 (0.03 to 1.91) | Very low certainty | 4 trials, 301 people |  |
| Mindfulness | adults | Core ADHD symptoms | self rated | 3 to 6 months | SMD 0.86 (0.41 to 1.31) | Very low certainty | 2 trials, 162 people |  |
| Mindfulness | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.93 (0.42 to 1.43) | Very low certainty | 4 trials, 264 people | [Try mindfulness gently](https://adhd100.jock.pl/try-mindfulness-gently/) |
| Mindfulness | adults | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 1.12 (0.05 to 2.18) | Very low certainty | 3 trials, 210 people |  |
| Mindfulness | adults | Depressive disorder symptoms | not split by rater | about 12 weeks | SMD 0.48 (0.02 to 0.95) | Very low certainty | 2 trials, 157 people |  |
| Mindfulness | adults | Emotional dysregulation | not split by rater | about 12 weeks | SMD 0.13 (-0.48 to 0.74) | Very low certainty | 2 trials, 103 people |  |
| Mindfulness | adults | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.76 (-0.3 to 1.83) | Very low certainty | 2 trials, 74 people |  |
| Mindfulness | adults | Exec. functions (tests) | not split by rater | 3 to 6 months | SMD 0.83 (0.1 to 1.55) | Very low certainty | 2 trials, 162 people |  |
| Mindfulness | adults | Generalized anxiety | self rated | about 12 weeks | SMD 0.73 (-0.3 to 1.75) | Very low certainty | 2 trials, 137 people |  |
| Mindfulness | adults | Quality of life | not split by rater | about 12 weeks | SMD -0.12 (-0.39 to 0.15) | Very low certainty | 2 trials, 223 people |  |
| Mindfulness | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.17 (-0.06 to 0.39) | Very low certainty | 4 trials, 257 people |  |
| Mindfulness | children and teens | Exec. functions (mixed) | not split by rater | about 12 weeks | SMD 0.44 (-0.08 to 0.97) | Very low certainty | 3 trials, 187 people |  |
| Modafinil | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.43 (-0.55 to 1.42) | Very low certainty | 2 trials, 257 people |  |
| Modafinil | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.3 (1.01 to 1.67) | Very low certainty | 6 trials, 809 people |  |
| Modafinil | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.47 (0.31 to 0.63) | Low certainty | 4 trials, 722 people |  |
| Modafinil | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD 0.49 (0.34 to 0.64) | Low certainty | 5 trials, 768 people |  |
| Modafinil | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.53 (0.35 to 0.72) | Low certainty | 4 trials, 524 people |  |
| Modafinil | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.79 (0.36 to 1.75) | Moderate certainty | 6 trials, 809 people |  |
| Multimodal behavioral interventions | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.39 (0.55 to 3.54) | Very low certainty | 5 trials, 584 people |  |
| Neurofeedback | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.59 (0.06 to 1.12) | Very low certainty | 2 trials, 54 people |  |
| Neurofeedback | adults | Exec. functions (tests) | self rated | about 12 weeks | SMD 0.13 (-0.31 to 0.56) | Very low certainty | 2 trials, 59 people |  |
| Neurofeedback | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.49 (0.88 to 2.53) | Very low certainty | 7 trials, 333 people |  |
| Neurofeedback | children and teens | Core ADHD symptoms | clinician rated | about 12 weeks | SMD -0.13 (-0.45 to 0.19) | Very low certainty | 3 trials, 274 people |  |
| Neurofeedback | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.13 (-0.01 to 0.28) | Low certainty | 10 trials, 587 people |  |
| Neurofeedback | children and teens | Core ADHD symptoms | parent rated | over 6 months | SMD 0.17 (-0.16 to 0.49) | Very low certainty | 2 trials, 121 people |  |
| Neurofeedback | children and teens | Core ADHD symptoms | parent rated | 3 to 6 months | SMD 0.3 (-0.01 to 0.6) | Very low certainty | 4 trials, 314 people |  |
| Neurofeedback | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.42 (0.24 to 0.61) | Very low certainty | 19 trials, 1195 people |  |
| Neurofeedback | children and teens | Exec. functions (report) | not split by rater | about 12 weeks | SMD 0.23 (-0.07 to 0.54) | Very low certainty | 2 trials, 125 people |  |
| Neurofeedback | children and teens | Exec. functions (report) | parent rated | about 12 weeks | SMD 0.43 (0.08 to 0.78) | Very low certainty | 3 trials, 126 people |  |
| Neurofeedback | children and teens | Exec. functions (tests) | not split by rater | 3 to 6 months | SMD 0.03 (-0.2 to 0.25) | Very low certainty | 3 trials, 279 people |  |
| Neurofeedback | children and teens | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.04 (-0.07 to 0.16) | Very low certainty | 17 trials, 920 people |  |
| Organizational skills interventions | children and teens | Academic/job performance | teacher rated | about 12 weeks | SMD 0.31 (0.17 to 0.45) | Very low certainty | 11 trials, 929 people | [Ask for organisational skills training](https://adhd100.jock.pl/request-child-organisational-training/), [Build a homework packing routine](https://adhd100.jock.pl/child-homework-materials-routine/) |
| Parent-mediated behavioral interventions | under 6 | Conduct disorder symptoms (CD) | parent rated | about 12 weeks | SMD 0.24 (-0.1 to 0.58) | Very low certainty | 3 trials, 315 people |  |
| Parent-mediated behavioral interventions | under 6 | Core ADHD symptoms | parent rated | 3 to 6 months | SMD 0.22 (-0.28 to 0.71) | Very low certainty | 3 trials, 164 people |  |
| Parent-mediated behavioral interventions | under 6 | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.63 (0.25 to 1.02) | Very low certainty | 5 trials, 399 people | [Ask about parent behaviour training](https://adhd100.jock.pl/seek-parent-behaviour-training/) |
| Parent-mediated behavioral interventions | under 6 | Oppositional symptoms (ODD) | parent rated | about 12 weeks | SMD 0.24 (0.01 to 0.48) | Very low certainty | 3 trials, 305 people |  |
| Parent-mediated behavioral interventions | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.01 (0.63 to 1.61) | Low certainty | 12 trials, 1123 people |  |
| Parent-mediated behavioral interventions | children and teens | Conduct disorder symptoms (CD) | parent rated | about 12 weeks | SMD 0.16 (0.06 to 0.27) | Low certainty | 12 trials, 1428 people |  |
| Parent-mediated behavioral interventions | children and teens | Core ADHD symptoms | parent rated | over 6 months | SMD 0.24 (0.03 to 0.44) | Very low certainty | 4 trials, 571 people |  |
| Parent-mediated behavioral interventions | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD 0.35 (0.14 to 0.55) | Very low certainty | 16 trials, 1625 people | [Praise a specific effort](https://adhd100.jock.pl/praise-specific-effort/) |
| Parent-mediated behavioral interventions | children and teens | Oppositional symptoms (ODD) | parent rated | about 12 weeks | SMD 0.25 (0.11 to 0.39) | Very low certainty | 13 trials, 1439 people | [Keep boundaries clear and calm](https://adhd100.jock.pl/keep-boundaries-calm/) |
| Parent-mediated behavioral interventions | children and teens | Oppositional symptoms (ODD) | parent rated | 3 to 6 months | SMD 0.3 (-0.02 to 0.62) | Very low certainty | 2 trials, 149 people |  |
| Physical training | children and teens | Acceptability | not split by rater | about 12 weeks | RR 1.1 (0.58 to 2.08) | Very low certainty | 6 trials, 232 people |  |
| Physical training | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.49 (0.23 to 0.75) | Very low certainty | 9 trials, 302 people | [Help your child find active fun](https://adhd100.jock.pl/child-enjoyable-exercise/) |
| Physical training | children and teens | Exec. functions (tests) | clinician rated | about 12 weeks | SMD 0.95 (0.64 to 1.27) | Very low certainty | 16 trials, 445 people |  |
| Physical training | children and teens | Social-communication skills | not split by rater | about 12 weeks | SMD 0.49 (-0.41 to 1.4) | Very low certainty | 4 trials, 90 people |  |
| Polyunsaturated fatty acids | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.9 (0.66 to 1.23) | Very low certainty | 8 trials, 603 people |  |
| Polyunsaturated fatty acids | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 3.04 (0.29 to 31.55) | Very low certainty | 2 trials, 122 people |  |
| Polyunsaturated fatty acids | children and teens | Conduct disorder symptoms (CD) | not split by rater | 3 to 6 months | SMD -0.11 (-0.32 to 0.1) | Very low certainty | 5 trials, 332 people |  |
| Polyunsaturated fatty acids | children and teens | Core ADHD symptoms | parent rated | 3 to 6 months | SMD 0.05 (-0.1 to 0.2) | Low certainty | 15 trials, 963 people | [Check omega 3 claims before buying](https://adhd100.jock.pl/omega-three-expectations/) |
| Polyunsaturated fatty acids | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD -0.37 (-1.09 to 0.35) | Very low certainty | 4 trials, 185 people |  |
| Polyunsaturated fatty acids | children and teens | Core ADHD symptoms | parent rated | about 12 weeks | SMD -0.26 (-0.56 to 0.04) | Very low certainty | 5 trials, 329 people |  |
| Polyunsaturated fatty acids | children and teens | Core ADHD symptoms | teacher rated | 3 to 6 months | SMD -0.06 (-0.24 to 0.12) | Low certainty | 6 trials, 498 people |  |
| Polyunsaturated fatty acids | children and teens | Oppositional symptoms (ODD) | not split by rater | 3 to 6 months | SMD -0.1 (-0.29 to 0.08) | Very low certainty | 5 trials, 423 people |  |
| Polyunsaturated fatty acids | children and teens | Quality of life | not split by rater | 3 to 6 months | SMD -0.01 (-0.31 to 0.28) | Very low certainty | 2 trials, 188 people |  |
| Polyunsaturated fatty acids | children and teens | Social-communication skills | not split by rater | 3 to 6 months | SMD -0.09 (-0.41 to 0.22) | Very low certainty | 2 trials, 145 people |  |
| Polyunsaturated fatty acids | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.89 (0.31 to 2.55) | Very low certainty | 7 trials, 584 people |  |
| Probiotics | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.93 (0.5 to 1.7) | Low certainty | 4 trials, 224 people |  |
| Probiotics | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.35 (-0.11 to 0.81) | Low certainty | 5 trials, 220 people |  |
| Risperidone | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.66 (0.38 to 1.16) | Very low certainty | 2 trials, 193 people |  |
| Social skill training | children and teens | Core ADHD symptoms | teacher rated | about 12 weeks | SMD 0.54 (-0.92 to 2) | Very low certainty | 2 trials, 83 people |  |
| Social skill training | children and teens | Social-communication skills | not split by rater | 3 to 6 months | SMD 0.12 (-0.31 to 0.55) | Very low certainty | 2 trials, 73 people |  |
| Social skill training | children and teens | Social-communication skills | not split by rater | about 12 weeks | SMD 0.25 (0.02 to 0.48) | Very low certainty | 5 trials, 270 people | [Practise friendship without pressure](https://adhd100.jock.pl/practise-friendship-without-promises/) |
| tDCS | adults | Acceptability | not split by rater | about 12 weeks | RR 0.34 (0.1 to 1.22) | Very low certainty | 3 trials, 103 people |  |
| tDCS | adults | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.43 (0.18 to 0.69) | Low certainty | 5 trials, 217 people |  |
| tDCS | adults | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.3 (0 to 0.6) | Very low certainty | 3 trials, 156 people |  |
| tDCS | adults | Tolerability | not split by rater | about 12 weeks | RR 0.35 (0.06 to 2.08) | Very low certainty | 2 trials, 81 people |  |
| tDCS | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD -0.22 (-0.79 to 0.35) | Very low certainty | 2 trials, 60 people |  |
| tDCS | children and teens | Exec. functions (tests) | not split by rater | about 12 weeks | SMD 0.15 (-0.04 to 0.34) | Low certainty | 11 trials, 370 people |  |
| TMS-rTMS | adults | Acceptability | not split by rater | about 12 weeks | RR 0.61 (0.3 to 1.25) | Very low certainty | 4 trials, 141 people |  |
| TMS-rTMS | adults | Core ADHD symptoms | self rated | about 12 weeks | SMD 0.03 (-0.5 to 0.55) | Very low certainty | 4 trials, 118 people |  |
| TMS-rTMS | adults | Tolerability | not split by rater | about 12 weeks | RR 1.07 (0.26 to 4.35) | Very low certainty | 3 trials, 115 people |  |
| Viloxazine | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.76 (0.54 to 1.08) | Low certainty | 5 trials, 990 people |  |
| Viloxazine | children and teens | AE (decreased appetite) | not split by rater | about 12 weeks | RR 0.18 (0.06 to 0.58) | Very low certainty | 3 trials, 606 people |  |
| Viloxazine | children and teens | AE (sleep problems) | not split by rater | about 12 weeks | RR 0.27 (0.16 to 0.46) | Moderate certainty | 5 trials, 990 people |  |
| Viloxazine | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.38 (0.26 to 0.5) | Moderate certainty | 5 trials, 990 people |  |
| Viloxazine | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.43 (0.19 to 1) | Very low certainty | 5 trials, 990 people |  |
| Vitamin D | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.42 (-0.21 to 1.05) | Very low certainty | 2 trials, 125 people |  |
| Vitamin D | children and teens | Oppositional symptoms (ODD) | not split by rater | about 12 weeks | SMD 0.95 (-0.22 to 2.13) | Very low certainty | 2 trials, 89 people |  |
| Zinc | children and teens | Acceptability | not split by rater | about 12 weeks | RR 0.96 (0.8 to 1.16) | Very low certainty | 4 trials, 536 people |  |
| Zinc | children and teens | Core ADHD symptoms | mixed raters | about 12 weeks | SMD 0.62 (0.07 to 1.18) | Very low certainty | 6 trials, 489 people |  |
| Zinc | children and teens | Tolerability | not split by rater | about 12 weeks | RR 0.7 (0.39 to 1.23) | Very low certainty | 2 trials, 456 people |  |

## Credit and license

Data from Gosling CJ, Garcia-Argibay M, De Prisco M, et al. Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making. BMJ 2025;391:e085875, doi:10.1136/bmj-2025-085875, published under CC BY 4.0. The authors' interactive platform is at ebiadhd-database.org.

- [Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making](10.1136/bmj-2025-085875)
- [EBI-ADHD](https://ebiadhd-database.org/)

Changes: the numbers are copied as published; this page only regroups them, labels them in plain English and links the items on the list that rest on them.

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General information about ADHD, not a diagnosis or an individual treatment plan. Tailoring changes the order of suggestions; it does not assess you. Medication decisions belong with you and a qualified clinician.

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