The most comprehensive review to date of ADHD treatments has found that medication for children and adults, and cognitive behavioural therapy for adults, remain the most effective approaches, backed by the strongest short-term trial evidence.
Researchers led by the Université Paris Nanterre (France), Institut Robert-Debré du Cerveau de l'Enfant (France), and the University of Southampton (UK) analysed over 200 meta-analyses covering different treatment types, participant groups, and clinical outcomes in a study published today [27 November 2027] in The BMJ.
The research was funded by public and peer-reviewed research grants from Agence Nationale de la Recherche (France), France 2030 program (France), and National Institute for Health and Care Research (UK).
To help people with attention deficit hyperactivity disorder (ADHD) and their clinicians make more informed, shared decisions, the team has created an interactive website that clearly presents the findings and the evidence behind each treatment based on the review (ebiadhd-database.org).
“We know that people with ADHD and their families are often overwhelmed by conflicting messages about which treatments work,” says Professor Samuele Cortese, an NIHR Research Professor at the University of Southampton and senior lead author on the paper.
“We believe this study and the accompanying website provide the most authoritative, evidence-based, and accessible guidance currently available.
“The Evidence-Based Interventions for ADHD website provides freely available, evidence-based, and continuously updated information in an easy-to-understand way. To the best of our knowledge, this is the first platform in the world to do so based on such a rigorous synthesis of the available evidence.”
Overall, five medications in children and adolescents, and two medications and cognitive behavioural therapy (CBT) in adults were shown to be effective while supported by a relatively robust evidence base. Critically, all this evidence was limited to the short-term, despite long-term treatment being common in clinical practice.
Treatments like acupuncture, mindfulness and exercise showed promise, but the evidence supporting their use was of a low quality due to small numbers of participants and risk of bias. The limitations applied to studies evaluating cognitive behavioural therapy in children and adolescents, as well as research on the long-term effects of mindfulness in adults, although mindfulness was the only intervention to demonstrate large beneficial effects at extended follow-up.
Dr Corentin Gosling, Associate Professor at the Paris Nanterre University and first lead author of the study, says: “Long waiting lists for mental health services are a major issue. Having incorrect information about treatments can make people’s journeys even more difficult, by wasting time and money on non-evidence-based approaches, for example.
“By contrast, taking the time to review all treatment options within a shared decision-making process using the web app we developed (ebiadhd-database.org) can empower people with ADHD, leading to better treatment adherence, improved outcomes, and an overall better patient experience.”
The findings generally complement current international clinical guidelines, not only by providing convenient access to current high-quality evidence, but also by covering interventions not usually mentioned in clinical guidelines.
The team hope this new project will achieve a similar impact in influencing clinical guidelines and practice as their previous project (ebiact-database.com), which looked at treatments for autism.
Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making is published in The BMJ and is available online.
Ends
Contact
Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.
Notes for editors
- Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making will be published in The BMJ. An advanced copy is available on request. It will be published at: https://www.bmj.com/content/391/bmj-2025-085875
- The Evidence-Based Interventions for ADHD website is available at: https://ebiadhd-database.org/
- For Interviews, please contact Steve Williams, Media Manager, University of Southampton press@soton.ac.uk or 023 8059 3212.
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Journal
The BMJ
Subject of Research
People
Article Title
Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making
Article Publication Date
27-Nov-2025
COI Statement
All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from French National Research Agency, France 2030 programme, and National Institute for Health and Care Research (NIHR); no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. GA is supported by grant RYC2020‐030744‐I funded by MCIN/AEI/10.13039/501100011033 and by “European Social Funds (ESF) Investing in your future.” AC has received honorariums for lectures from Janssen, Lundbeck, and Rovi in the past years, outside of her current employment. She has also received research funding from Instituto de Salud Carlos III and the Basque Government. AC is supported by the NIHR Oxford Cognitive Health Clinical Research Facility, an NIHR research professorship (grant RP-2017-08-ST2-006), the NIHR Oxford and Thames Valley Applied Research Collaboration, the NIHR Oxford Health Biomedical Research Centre (grant NIHR203316), and the Wellcome Trust (GALENOS Project),and has received research, educational, and consultancy feesfrom INCiPiT (Italian Network for Paediatric Trials), CARIPLO Foundation, Lundbeck, and Angelini Pharma. SC has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Mental Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian AADHD Alliance Resource, the British Association of Psychopharmacology, Healthcare Convention, and CCM Group team for educational activity on ADHD, and has received honorariumsfrom Medice. CUC has been a consultant and/or advisor to, or hasreceived honorariums from, AbbVie, Alkermes, Allergan, Angelini, Aristo, Autobahn, Boehringer-Ingelheim, Bristol-Meyers Squibb, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Delpor, Denovo, Draig, Eli Lilly, Eumentis Therapeutics, Gedeon Richter, GH, Hikma, Holmusk, IntraCellular Therapies, Jamjoom Pharma, Janssen/Johnson & Johnson, Karuna, LB Pharma, Lundbeck, MedInCell, MedLink, Merck, Mindpax, Mitsubishi Tanabe Pharma, Maplight, Mylan, Neumora Therapeutics, Neuraxpharm, Neurocrine, Neurelis, Newron, Noven, Novo Nordisk, Otsuka, PPD Biotech, Recordati, Relmada, Response Pharmaceutical, Reviva, Rovi, Saladax, Sanofi, Seqirus, Servier, Sumitomo Pharma America, Sunovion, Sun Pharma, Supernus, Tabuk, Takeda, Teva, Terran, Tolmar, Vertex, Viatris, and Xenon Pharmaceuticals. He provided expert testimony for Janssen, Lundbeck, and Otsuka. He served on a data safety monitoring board for Compass Pathways, IntraCellular Therapies, Relmada, Reviva, and Rovi. He has received grant support from Boehringer-Ingelheim, Janssen, and Takeda. He received royalties from UpToDate and is also a stock option holder of Cardio Diagnostics, Kuleon Biosciences, LB Pharma, MedLink Global, Mindpax, Quantic, Terran. GF hasreceived grants and served as a paid consultant, adviser, orcontinuing medical education (CME) speaker for Angelini, Janssen, Viatris, Robi, Lundbeck, and Sanofi-Aventis. PFP issupported by #NEXTGENERATIONEU (NGEU) funded by the Ministry of University and Research (MUR), National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006) – A Multiscale integrated approach to the study of the nervous system in health and disease (DN. 1553 11.10.2022). He hasreceived research funds or personal feesfrom Lundbeck, Angelini, Menarini, Sunovion, Boehringer Ingelheim, Proxymm Science, Otsuka, and Gedeon Richter, outside the submitted work. MH received honorariums/has been a consultant for Lundbeck and Otsuka. LJ hasreceived honorariumsfrom Servier and Biocodex. She hasreceived a research mobility grant from La Fondation Planiol. HL acknowledges financial support from the Swedish Research Council (2024-06592). He also reports receiving grants from Shire Pharmaceuticals and personal feesfrom and serving as a speaker for Medice, Shire/Takeda Pharmaceuticals, and Evolan Pharma, all outside the submitted work. HL is editor in chief of JCPP Advances. EGO has received consultancy fees from Angelini Pharma outside of the submitted work. PFP hasreceived research funds or personal feesfrom Recordati, Lundbeck, Angelini, Menarini, Sunovion, Boehringer Ingelheim, Proxymm Science, Otsuka, Gedeon Richter, and CurieBio outside the current work. MDP is supported by the Translational Research Programme for Brain Disorders, IDIBAPS. VO issupported by a Rio Hortega 2024 grant (CM24/00143) from the Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and co-financed by the Fondo Social Europeo Plus (FSE+). JR has received CME honorariums from Inspira Networks for a machine learning course promoted by Adamed, outside the submittedwork. GSDP hasreceived fees/honorariumsfrom Lundbeck and Janssen. JIS has been supported by the Yonsei Fellowship, funded by Lee Youn Jae. MS received honorariums/has been a consultant for Angelini, AbbVie, Bausch Health, Boehringer Ingelheim, Lundbeck, Otsuka. AT has received research, educational and consultancy fees from Angelini Pharma, and lecture fees from Takeda, outside the submitted work. She also acts as a clinical advisor for Akrivia Health. SJW has received funding from NIHR i4i grant (NIHR207448). The views expressed are those of the authors and not necessarily those of the UK NHS, NIHR, or UK Department of Health and Social Care.