CARBAMAZEPINE USE IN CHILDREN AND ADOLESCENTS WITH FEATURES OF ATTENTION-DEFICIT HYPERACTIVITY DISORDER - A METAANALYSIS

Objective: In the United States approximately 750,000 children receive psychostimulants to treat attention-deficit hyperactivity disorder (A DHD); up to 25% may not respond. The purpose of this study was to eval uate the reports in the international literature concerning the effica cy of carbamazepine (CBZ) in children with ADHD features by means of m eta-analysis. Method: A review of the world literature located 29 repo rts that dealt with behavior problems, activity levels, and CBZ in chi ldren. Of these, only 10 reports provided sufficient or pertinent info rmation for the meta-analysis. Results: In all seven open studies, the rapeutic responses were significant (ranging from p = .05 to .0001, tw o-tailed t test). Meta-analysis using weighted variables revealed a si gnificant positive correlation (r = .88; p < .02) between duration of treatment and positive outcome. In three double-blind placebo-controll ed studies, treatment effects for CBZ's superiority over placebo range d from p = .07 to .0001. A meta-analysis of these three studies reveal ed that CBZ was significantly (p = .018) more effective than placebo a t controlling target symptoms. Conclusions: Despite the general lack o f attention that CBZ has received for treating ADHD, there is prelimin ary evidence that CBZ may be an effective alternate treatment in child ren with features of ADHD.