Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children,…
Why is methylphenidate usually the first-choice stimulant for children, and what specific improvements should we look for to know it is working?
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: Funders were independent, but several co-authors disclose consulting or speaker fees from ADHD drug manufacturers; head-to-head evidence at 12 weeks says little about long-term outcomes.
Across 133 randomized trials, methylphenidate reduced ADHD symptoms in children and adolescents more than placebo (clinician-rated SMD -0.78, teacher-rated SMD -0.82) and was better tolerated than amphetamines, supporting it as the preferred first-choice stimulant for young people.
Worth asking
Why is methylphenidate usually the first-choice stimulant for children, and what specific improvements should we look for to know it is working?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Attention-deficit/hyperactivity disorder (ADHD)
- Narcolepsy
Source
Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis — Cortese S, et al. (2018)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1016/S2215-0366(18)30269-4
DOI: 10.1016/S2215-0366(18)30269-4
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 18,199
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 100 out of 100 on our published rubric. One caveat travels with that badge: Funders were independent, but several co-authors disclose consulting or speaker fees from ADHD drug manufacturers; head-to-head evidence at 12 weeks says little about long-term outcomes. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis — Cortese S, et al. (2018). Published in: Top-tier peer-reviewed journal. DOI: 10.1016/S2215-0366(18)30269-4. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Meta-analysis of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is methylphenidate (Ritalin, Concerta, Metadate, Daytrana, Quillivant, Jornay), ritalin, concerta, metadate, daytrana, quillivant, jornay FDA approved?
Yes — FDA approved for Attention-deficit/hyperactivity disorder (ADHD), Narcolepsy. Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.