A related commentary discusses this research. There are some limitations to take into account. The network meta-analysis was unable to address a major challenge in ADHD treatment, which is the high rate of discontinuation that occurs around puberty despite continuation and even increased severity of impairments at that age. Also, the network plots in the current network meta-analysis, in which placebo dominates the picture, underscore the need for a paradigm shift toward comparative treatment research.
These results—and particularly limitations of the data obtained—call for future research that translates directly to clinical practice. Ultimately, this need will require funding agencies to support longitudinal and active comparison designs, attention to sequencing and combining pharmacological and behavioural interventions, and development of big datasets that permit identification of patient predictors, which have thus far remained elusive.