Azapirones for Attention Deficit Hyperactivity Disorder: A Systematic Review

Pharmacopsychiatry. 2016 May;49(3):97-106. doi: 10.1055/s-0042-102457. Epub 2016 Apr 13.

Abstract

Introduction: No meta-analysis has evaluated azapirones (serotonin1A receptor partial agonists) as anxiolytics for attention deficit hyperactivity disorder (ADHD).

Methods: Randomized controlled trials (RCTs) and single-arm trials published before October 27, 2015 were retrieved from major healthcare databases and clinical trial registries. Relative risk and 95% confidence intervals were calculated.

Results: 5 RCTs (n=429) and 3 single-arm studies (n=70) were identified. 3 RCTs compared buspirone vs. methylphenidate in children/adolescents, one buspirone patches vs. placebo patches in children/adolescents, and one atomoxetine plus buspirone vs. atomoxetine vs. placebo in adults. The single-arm studies were buspirone trails in children/adolescents. All-cause discontinuation rates and adverse events did not differ between pooled buspirone and methylphenidate groups. No other meta-analyses of buspirone efficacy and safety vs. comparators were conducted due to insufficient data. 2 RCTs found no significant differences in parent and teacher ADHD-Rating Scale total scores between buspirone and methylphenidate, while one reported that methylphenidate improved parent and teacher ADHD-RS total scores vs. buspirone.

Discussion: It remains unclear whether buspirone use has benefit for ADHD patients and therefore further evidence is needed for better clinical use of buspirone in patients with ADHD.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Buspirone / chemistry
  • Buspirone / therapeutic use*
  • Humans
  • Randomized Controlled Trials as Topic
  • Serotonin Receptor Agonists / therapeutic use*

Substances

  • Serotonin Receptor Agonists
  • Buspirone