Condition

ADHD

Attention-deficit/hyperactivity disorder

366.3M

People Affected

164

Active Trials

1.8M

New Cases/Year

200

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Amphetamines (Mixed Amphetamine Salts, Lisdexamfetamine)

90% Effectiveness• 95% Confidence• 60% Safety• 7 trials• 400K participants

HIGH EvidenceExcellent ValueDose: 5-40mg daily (amphetamine equivalent), tailored to individual

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Immediate (within 30-60 minutes for IR, 1-2 hours for ER)

Duration

Lifetime (as needed)

Response Rate

80%

Remission Rate

45%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Insomnia: 30%

Decreased appetite/weight loss: 30%

Headache: 15%

Abdominal pain: 12%

Irritability/anxiety: 12%

Increased heart rate/blood pressure: 8%

Annual Cost of Care

Drug Cost

$1,000

Monitoring

$300

Side Effects

$75

Total Annual

$1,375

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$18,000/QALY

Cost per Remission

$3,055.56

Cost per Responder

$1,718.75

Treatment Outcomes

Primary Outcomes

ADHD Symptom Severity (ADHD-RS-IV Total Score)45/54 points (moderate-severe ADHD)

-40% (-18 points)

Clinical Global Impression - Severity (CGI-S)4.5/7 (moderately ill)

-33% (-1.5 points)

Functional Impairment (WFIRS-S Total Score)60/100 points (significant impairment)

-35% (-21 points)

Secondary Benefits

Health-Related Quality of Life (ADQoL Total Score)60/100 points (below average)

+18% (+10.8 points)

Inattention Symptoms (ADHD-RS-IV Inattention Subscale)25/27 points

-38% (-9.5 points)

Hyperactivity-Impulsivity Symptoms (ADHD-RS-IV Hyperactivity/Impulsivity Subscale)20/27 points

-42% (-8.4 points)

Common Side Effects

Insomnia

+30%

Decreased appetite/weight loss

+30%

Headache

+15%

Clinical Trial Phases:

Phase 4

Methylphenidate (Ritalin, Concerta)

85% Effectiveness• 95% Confidence• 60% Safety• 341 trials• 500K participants

HIGH EvidenceExcellent ValueDose: 10-60mg daily (methylphenidate equivalent), tailored to individual

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Immediate (within 30-60 minutes for IR, 1-2 hours for ER)

Duration

Lifetime (as needed)

Response Rate

75%

Remission Rate

40%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Insomnia: 25%

Decreased appetite/weight loss: 25%

Headache: 15%

Abdominal pain: 12%

Irritability/mood swings: 8%

Increased heart rate/blood pressure: 8%

Annual Cost of Care

Drug Cost

$800

Monitoring

$300

Side Effects

$75

Total Annual

$1,175

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$15,000/QALY

Cost per Remission

$2,937.5

Cost per Responder

$1,567

Treatment Outcomes

Primary Outcomes

ADHD Symptom Severity (ADHD-RS-IV Total Score)ADHD-RS-IV Total Score: 42/54

-40% (-16.8 points)

Clinical Global Impression - Severity (CGI-S)CGI-S Score: 4.5/7

-44.4% (-2 points)

Inattention Symptoms (ADHD-RS-IV Inattention Subscale)ADHD-RS-IV Inattention Subscale Score: 24/27

-45% (-10.8 points)

Hyperactivity/Impulsivity Symptoms (ADHD-RS-IV Hyperactivity/Impulsivity Subscale)ADHD-RS-IV Hyperactivity/Impulsivity Subscale Score: 18/27

-35% (-6.3 points)

Secondary Benefits

Academic Productivity/Functional Impairment (WFIRS-P Total Score)WFIRS-P Total Score: 2.7/3

-44.4% (-1.2 points)

Health-Related Quality of Life (PedsQL Psychosocial Health Summary Score)PedsQL Psychosocial Health Summary Score: 60/100

+16.7% (+10 points)

Executive Functioning (BRIEF-P Global Executive Composite T-score)BRIEF-P GEC T-score: 70

-14.3% (-10 T-score points)

Common Side Effects

Insomnia

+25%

Decreased appetite/weight loss

+25%

Headache

+15%

Clinical Trial Phases:

Phase 4

Cognitive Behavioral Therapy (CBT) for ADHD

70% Effectiveness• 90% Confidence• 95% Safety• 63 trials• 25K participants

MODERATE EvidenceExcellent ValueDose: 12-16 weekly sessions of 45-60 minutes, plus daily practice

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

8-12 weeks for noticeable improvements

Duration

12-16 weekly sessions, then maintenance as needed

Response Rate

55%

Remission Rate

15%

Number Needed to Treat (NNT)

Common Side Effects:

Initial discomfort/frustration with tasks: 8%

Time commitment: 100%

Annual Cost of Care

Drug Cost

Monitoring

$500

Side Effects

Total Annual

$2,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.06

ICER

$41,667/QALY

Cost per Remission

$16,666.67

Cost per Responder

$4,545.45

Treatment Outcomes

Primary Outcomes

ADHD Symptom SeverityCAARS-S:L T-score: 72

-19.4% (-14 points on CAARS-S:L T-score)

Inattention SymptomsCAARS-S:L Inattention T-score: 75

-21.3% (-16 points on CAARS-S:L Inattention T-score)

Executive Functioning DifficultiesBRIEF-A GEC T-score: 70

-18.6% (-13 points on BRIEF-A GEC T-score)

Functional ImpairmentWSAS score: 28/40

-32.1% (-9 points on WSAS score)

Secondary Benefits

Quality of LifeAAQoL score: 55/100

+14.5% (+8 points on AAQoL score)

Self-EsteemRSES score: 15/30

+20% (+3 points on RSES score)

Anxiety SymptomsGAD-7 score: 12/21

-25% (-3 points on GAD-7 score)

Common Side Effects

Initial discomfort/frustration with tasks

+8%

Time commitment

+100%

Clinical Trial Phases:

Phase 4

Atomoxetine

60% Effectiveness• 90% Confidence• 65% Safety• 136 trials• 30K participants

HIGH EvidenceExcellent ValueDose: 40-100mg daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 weeks for initial effects, 6-12 weeks for full effect

Duration

Long-term (as needed)

Response Rate

45%

Remission Rate

20%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Nausea/vomiting/abdominal pain: 15%

Insomnia: 12%

Dry mouth: 10%

Headache: 10%

Decreased appetite: 8%

Increased heart rate/blood pressure: 5%

Annual Cost of Care

Drug Cost

$600

Monitoring

$200

Side Effects

$50

Total Annual

$850

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.04

ICER

$21,250/QALY

Cost per Remission

$4,250

Cost per Responder

$1,888.89

Treatment Outcomes

Primary Outcomes

ADHD-RS-IV Total Score38/54 points

-34% (-13 points)

ADHD-RS-IV Inattention Subscale Score19/27 points

-37% (-7 points)

ADHD-RS-IV Hyperactivity/Impulsivity Subscale Score19/27 points

-32% (-6 points)

Secondary Benefits

WFIRS-P Total Score35/90 points

-26% (-9 points)

PedsQL ADHD Module Total Score60/100 points

+13% (+8 points)

Parent Stress Index (PSI) Total Score90/150 points

-17% (-15 points)

Common Side Effects

Nausea/vomiting/abdominal pain

+15%

Insomnia

+12%

Dry mouth

+10%

Clinical Trial Phases:

Phase 4

Guanfacine Extended Release

55% Effectiveness• 85% Confidence• 65% Safety• 18 trials• 7K participants

MODERATE EvidenceExcellent ValueDose: 1-7mg daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks for initial effects, 3-4 weeks for full effect

Duration

Long-term (as needed)

Response Rate

40%

Remission Rate

15%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Sedation/somnolence: 25%

Fatigue: 15%

Dizziness: 12%

Headache: 10%

Abdominal pain: 7%

Hypotension/bradycardia: 6%

Annual Cost of Care

Drug Cost

$700

Monitoring

$250

Side Effects

$50

Total Annual

$1,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

ICER

$33,333/QALY

Cost per Remission

$6,666.67

Cost per Responder

$2,500

Treatment Outcomes

Primary Outcomes

ADHD-RS-IV Total ScoreADHD-RS-IV Total Score: 36/54

-44.4% (-16 points)

ADHD-RS-IV Hyperactivity/Impulsivity SubscaleADHD-RS-IV Hyperactivity/Impulsivity Subscale: 18/27

-44.4% (-8 points)

ADHD-RS-IV Inattention SubscaleADHD-RS-IV Inattention Subscale: 18/27

-38.9% (-7 points)

SWAN Total Score (Teacher-rated)SWAN Total Score (Teacher-rated): 2.5 (mean item score, 0-3 scale)

-24% (-0.6 points)

Secondary Benefits

CGI-S ScoreCGI-S Score: 4.5/7

-22.2% (-1.0 points)

Parent Stress Index (PSI) Total Stress ScorePSI Total Stress Score: 105/150

-9.5% (-10 points)

Working Memory Index (WMI)Working Memory Index (WMI, Wechsler Intelligence Scale): 85/190

+7.1% (+6 points)

Common Side Effects

Sedation/somnolence

+25%

Fatigue

+15%

Dizziness

+12%

Clinical Trial Phases:

Phase 4