Should clinicians start treating children and youth diagnosed with ADHD with stimulant or nonstimulant classes of medications? Answering this question will inform clinicians of which class of medications should treatment start with, and for which patients, as well as which outcomes are best served by which medication class. By identifying patients suitable for non-stimulants, this work may reduce the use of stimulants, addressing two public health concerns: misuse, abuse, and diversion, and medication shortages.
The purpose of this clinical trial is to generate high-quality real-world evidence to inform clinical decision-making on whether stimulant or nonstimulant medications should be the preferred first-line treatment for youth diagnosed with ADHD. The study will assess:
• The comparative effectiveness of stimulant first vs. nonstimulant-first strategies.
• The heterogeneity of treatment effects (HTE) among different patient subgroups.
• Treatment patterns over time in youth who begin treatment with stimulant vs nonstimulant medication
• Long-term outcomes in relation to treatment trajectory
This study aligns with national priorities in mental and behavioral health, aiming to improve outcomes for children with ADHD and optimize clinical practice guidelines. It also aligns with PCORIs stated interest in ADHD and its treatment.