Psychiatry Investig.  2025 Feb;22(2):140-147. 10.30773/pi.2024.0204.

Multidimensional Comparison of Methylphenidate and Atomoxetine in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children, a 12-Week, Open-Label, Head-to-Head Clinical Trial

• Chen L
• Du W

• KMID: 2564766
• DOI: http://doi.org/10.30773/pi.2024.0204

Abstract

Objective
To compare the treatment efficacy of methylphenidate and atomoxetine on core symptoms, behavioral and emotional problems, and executive function in children with attention-deficit/hyperactivity disorder (ADHD).
Methods
Sixty children with ADHD diagnosed by the fifth edition Diagnostic and Statistical Manual of Mental Disorders in Tangshan Maternal and Child Health Hospital from 2023 to 2024 were randomly divided into methylphenidate and atomoxetine groups. Core symptoms were assessed using the Parent Swanson, Nolan, and Pelham, Version IV Scale (SNAP-IV) and Integrated Visual and Auditory Continuous Performance Test (IVA-CPT). Behavioral and emotional problems were administered via the Conners Parent Symptom Questionnaire (PSQ) and executive function was evaluated utilizing the Wisconsin Card Sorting Test (WCST) and Digit Span Test (DST). All data were analyzed using SPSS 26.00 to identify discrepancies.
Results
When contrasted with the methylphenidate and atomoxetine groups at 12 weeks, their mean efficiency was no significant disparity (p>0.05). Notable statistical differences were evident in IVA-CPT, the inattention, hyperactivity-impulsivity of SNAP-IV, and the psychosomatic disorder, anxiety, and hyperactivity-impulsivity of PSQ (p<0.05), yet in hyperactivity index, conduct, and learning difficulties of PSQ (p>0.05). No statistical significance was attributed to DST and the number of completed categories in WCST (p>0.05) but to response errors and perseverative errors (p<0.05).
Conclusion
Although both methylphenidate and atomoxetine are capable of effectively ameliorating ADHD, methylphenidate demonstrates a superior ability to improve core symptoms of ADHD, as well as address conduct problems, cognitive transfer abilities, and frontal lobe function in pediatric patients. Conversely, atomoxetine is the best choice for cases comorbid with anxiety.

Keyword

Attention-deficit/hyperactivity disorder; Methylphenidate; Atomoxetine; Treatment efficacy; Multidimensional comparison