Cognitive effectiveness of methylphenidate and atomoxetine in attention deficit hyperactivity disorder: a review
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https://doi.org/10.31766/revpsij.v33n3a1Keywords:
Atomoxetine, Child, Child Neuropsychology, Child Psychiatry, Methylphenidate, Neuropsychological AssessmentAbstract
Introduction. There is growing scientific agreement that attention deficit hyperactivity disorder (ADHD) is associated with significant deficits in several cognitive domains. This assertion has cognitive-behavioral and neurophysiological evidence. Drug therapy is traditionally focused in reducing or eliminating the nuclear symptoms of the disorder (inattention, hyperactivity and impulsivity) to adaptative levels. Methyphenidate (MTF) and Atomoxetine (ATX) are two of the most popular medications for this population. Both act on the prefrontal cortex and its connections to the basal ganglia, circuits related as well to the anatomical substrate of attention, motor activity and inhibitory control. If we consider that these regions are also involved in complex cognitive processing likewise, we can conclude that, the pharmachological approaches that are effective in improving nuclear symptoms of this disorder, will have a beneficial effect on cognitive performance of these patients, and by extension on academic performance.
Objective. This literature review pretend to update existing knowledge on cognitive impact of methylphenidate or atomoxetine administration in people with ADHD. We aim to deepen in the relationship between nuclear symptoms, pathologic substrate and cognitive performance with special reference to executive functions.
Methods. We have done an extensive literature review in PubMed, PsycINFO and Medline databases with the keywords: Methylphenidate, atomoxetine, ADHD, Treatment, Neuropsychological assessment and child neuropsychology.
Conclusions: methylphenidate has shown superiority to atomoxetine in controlling nuclear symptomatology, however, on cognitive functioning, particularly on working memory, both drugs show comparable beneficial effects in some studies.
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