human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare methylpheni date ( MPH ) and dexamphetamine ( DEX ) in a sample of children with attention deficit hyperactivity disorder ( ADHD ) . METHOD A total of 125 children with ADHD received both MPH ( 0.3 mg/kg twice daily ) and DEX ( 0.15 mg/kg twice daily ) for 2 weeks a double-blind , crossover study . Outcome measures were Conners ' Parent Rating Scale-Revised , Conners ' Teacher Rating Scale-Revised , a Parent Global Perceptions question naire , the Continuous Performance Test , and the Barkley Side Effects Rating Scale . RESULTS There were significant group mean improvements from baseline score on all measures for both stimulants . On the Conners ' Teacher Rating Scale-Revised , response was greater on MPH than DEX on the conduct problems and hyperactivity factors , as well as on the hyperactivity index . On the Conners ' Parent Rating Scale-Revised , anxiety was the only factor to differ significantly , in favor of MPH . Parents rated 73 % of subjects as globally improved on MPH and 69 % improved on DEX , compared with baseline . Overall , 46 % of parents chose MPH as the preferred drug , compared with 37 % who chose DEX . On the Continuous Performance Test , there was no difference in the number of correct responses or errors between the two drugs . CONCLUSIONS Most children with ADHD improve significantly on both MPH and DEX . There was a slight advantage to MPH on most measures Objective : Attention-deficit/hyperactivity disorder ( ADHD ) is the most common neurobehavioral disorder of childhood . Principal treatment options for ADHD today include the psychostimulants , mainly methylpheni date ( MPH ) . However , approximately 30 % to 50 % of children and adults with ADHD either do not respond to or do not tolerate treatment with stimulants . In this 8-week open-label , MPH-controlled , parallel group design study , we investigate the efficacy of reboxetine , a new selective norepinephrine reuptake inhibitor , in the treatment of boys with ADHD with a history of intolerance to MPH therapy . Method : Twenty-seven outpatient boys , aged 6 to 16 years , diagnosed with ADHD , participated in the study . Those with a history of intolerance to MPH therapy were assigned to treatment with reboxetine ( 2 - 8 mg/d ) , and the rest were assigned to treatment with MPH ( 10 - 20 mg/d ) as the control group . The primary outcome measure for this study was the change in rating scores on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition , ADHD Scale ( DAS ) that was assessed at baseline and at 8 weeks . Results : At the end of 8 weeks , both reboxetine and MPH treatment regimens result ed in significant improvement in ADHD symptoms . The change in the reduction in the total DAS score and the DAS subscale scores between the reboxetine group and the MPH group was not statistically significant in any of the scores . Conclusions : Although preliminary , results of this study indicate that the use of reboxetine , a new selective norepinephrine reuptake inhibitor , in the treatment of ADHD could increase treatment options available for children who have shown intolerance or who are unresponsive to MPH Twenty-two children with attention deficit-hyperactivity disorder underwent a double-blind , placebo-controlled , crossover evaluation of the efficacy of st and ard methylpheni date twice a day and comparable doses every morning of a sustained-release preparation of methylpheni date ( SR-20 Ritalin ) , a sustained-release form of dextroamphetamine ( Dexedrine Spansule ) , and pemoline . The children were participating in a summer treatment program in which they engaged in recreational and classroom activities . Dependent measures include evaluations of social behavior during group recreational activities , classroom performance , and performance on a continuous performance task . Results revealed generally equivalent and beneficial effects of all four medications . Dexedrine Spansule and pemoline tended to produce the most consistent effects and were recommended for 10 of the 15 children who were responders to medication . The continuous performance task results showed that all four medications had an effect within 2 hours of ingestion , and the effects lasted for 9 hours . The implication s of these results for the use of long-acting stimulant medication in children with attention deficit-hyperactivity disorder are discussed Objectives The aim of this study was to compare the efficacy and safety of the prodrug psychostimulant lisdexamfetamine dimesylate ( LDX ) and the non-stimulant noradrenergic compound atomoxetine ( ATX ) in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) who had previously responded inadequately to methylpheni date ( MPH ) . Methods This 9-week , head-to-head , r and omized , double-blind , active-controlled study ( SPD489 - 317 ; Clinical Trials.gov NCT01106430 ) enrolled patients ( aged 6–17 years ) with at least moderately symptomatic ADHD and an inadequate response to previous MPH therapy . Patients were r and omized ( 1:1 ) to an optimized daily dose of LDX ( 30 , 50 or 70 mg ) or ATX ( patients < 70 kg , 0.5–1.2 mg/kg with total daily dose not to exceed 1.4 mg/kg ; patients ≥70 kg , 40 , 80 or 100 mg ) . The primary efficacy outcome was time ( days ) to first clinical response . Clinical response was defined as a Clinical Global Impressions-Improvement ( CGI-I ) score of 1 ( very much improved ) or 2 ( much improved ) . Secondary efficacy outcomes included the proportion of responders at each study visit and the change from baseline in ADHD Rating Scale ( ADHD-RS-IV ) and CGI-Severity scores . Tolerability and safety were assessed by monitoring treatment-emergent adverse events ( TEAEs ) , height and weight , vital signs and electrocardiogram parameters . Endpoint was defined as the last post-baseline , on-treatment visit with a valid assessment . Results Of 267 patients r and omized ( LDX , n = 133 ; ATX , n = 134 ) , 200 ( 74.9 % ) completed the study . The median time to first clinical response [ 95 % confidence interval ( CI ) ] was significantly shorter for patients receiving LDX [ 12.0 days ( 8.0–16.0 ) ] than for those receiving ATX [ 21.0 days ( 15.0–23.0 ) ] ( p = 0.001 ) . By week 9 , 81.7 % ( 95 % CI 75.0–88.5 ) of patients receiving LDX had responded to treatment compared with 63.6 % ( 95 % CI 55.4–71.8 ) of those receiving ATX ( p = 0.001 ) . Also by week 9 , the difference between LDX and ATX in least-squares mean change from baseline ( 95 % CI ) was significant in favour of LDX for the ADHD-RS-IV total score [ −6.5 ( −9.3 to −3.6 ) ; p < 0.001 ; effect size 0.56 ] , inattentiveness subscale score [ −3.4 ( −4.9 to −1.8 ) ; p < 0.001 ; effect size 0.53 ] and the hyperactivity/impulsivity subscale score [ −3.2 ( −4.6 to −1.7 ) ; p < 0.001 ; effect size 0.53 ] . TEAEs were reported by 71.9 and 70.9 % of patients receiving LDX and ATX , respectively . At endpoint , both treatments were associated with mean ( st and ard deviation ) increases in systolic blood pressure [ LDX , + 0.7 mmHg ( 9.08 ) ; ATX , + 0.6 mmHg ( 7.96 ) ] , diastolic blood pressure [ LDX , + 0.1 mmHg ( 8.33 ) ; ATX , + 1.3 mmHg ( 8.24 ) ] and pulse rate [ LDX , + 3.6 bpm ( 10.49 ) ; ATX , + 3.7 bpm ( 10.75 ) ] , and decreases in weight [ LDX , −1.30 kg ( 1.806 ) ; ATX , −0.15 kg ( 1.434 ) ] . Conclusions LDX was associated with a faster and more robust treatment response than ATX in children and adolescents with at least moderately symptomatic ADHD who had previously responded inadequately to MPH . Both treatments displayed safety profiles consistent with findings from previous clinical trials This study evaluated the efficacy and safety of lisdexamfetamine dimesylate ( LDX ) compared with placebo in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) in Europe .  Osmotic-release oral system methylpheni date ( OROS-MPH ) was included as a reference arm . Patients ( 6 - 17 years old ) with a baseline ADHD Rating Scale version IV ( ADHD-RS-IV ) total score ≥ 28 were r and omized ( 1:1:1 ) to dose-optimized LDX  ( 30 , 50 , or 70 mg/day ) , OROS-MPH ( 18 , 36 , or 54 mg/day ) or placebo for 7 weeks . Primary and key secondary efficacy measures were the investigator-rated ADHD-RS-IV and the Clinical Global Impressions-Improvement ( CGI-I ) rating , respectively . Safety assessment s included treatment-emergent adverse events ( TEAEs ) , electrocardiograms , and vital signs . Of 336 patients r and omized , 196 completed the study . The difference between LDX and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -18.6 ( 95 % confidence interval [ CI ] : -21.5 to -15.7 ) ( p<0.001 ; effect size , 1.80 ) . The difference between OROS-MPH and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -13.0 ( 95 % CI : -15.9 to -10.2 ) ( p<0.001 ; effect size , 1.26 ) . The proportions ( 95 % CI ) of patients showing improvement ( CGI-I of 1 or 2 ) at endpoint were 78 % ( 70 - 86 ) , 14 % ( 8 - 21 ) , and 61 % ( 51 - 70 ) for LDX , placebo , and OROS-MPH . The most common TEAEs for LDX were decreased appetite , headache , and insomnia . Mean changes in vital signs were modest and consistent with the known profile of LDX . LDX was effective and generally well tolerated in children and adolescents with ADHD The efficacy and side effects of buspirone compared with methylpheni date ( MPH ) in the treatment of children with attention-deficit/hyperactivity disorder ( ADHD ) . A total of 34 children with ADHD as defined by DSM-IV-TR were r and omized to buspirone or methylpheni date dosed on weight-adjusted basis at buspirone ( 0.5 mg/kg/day ) and methylpheni date ( 0.3–1 mg/kg/day ) for a 6-week double-blind clinical trial . The principle measures of outcome were the teacher and parent ADHD Rating Scale . The side effects were assessed by the special side effect checklist of each drug . In both groups , the scores of teacher and parent ADHD Rating Scale significantly declined on the 6th week as compared to baseline ( p = 0.001 ) . These effects were observed in the subscales too . No significant differences were observed between the two protocol s on the total scores of parent and teacher ADHD Rating Scale , but methylpheni date was superior to buspirone in decreasing the symptoms of inattention . The side effects of buspirone were mild and rare in comparison with MPH . Buspirone has a favorable side-effects profile . It also has clinical ly and statistically significant impacts on improving the ADHD symptoms in children . These preliminary findings of the efficacy of buspirone in children with ADHD need large and cross-over studies Attention-deficit/hyperactivity disorder ( ADHD ) is associated with functional impairments in multiple domains of patients ’ lives . A secondary objective of this r and omized , active-controlled , head-to-head , double-blind , dose-optimized clinical trial was to compare the effects of lisdexamfetamine dimesylate ( LDX ) and atomoxetine ( ATX ) on functional impairment in children and adolescents with ADHD . Patients aged 6–17 years with an ADHD Rating Scale IV total score ≥28 and an inadequate response to methylpheni date treatment ( judged by investigators ) were r and omized ( 1:1 ) to once-daily LDX or ATX for 9 weeks . Parents/guardians completed the Weiss Functional Impairment Rating Scale-Parent Report ( WFIRS-P ) at baseline and at week 9 or early termination . p values were nominal and not corrected for multiple comparisons . Of 267 r and omized patients , 200 completed the study ( LDX 99 , ATX 101 ) . At baseline , mean 
    Output:
    
agent
On the CGI-I scale , the analysis revealed that MPH was more effective than ATX and GXR .
For any adverse events , RBX ( 89 % ) was the safest alternative .
Network meta- analysis offered a broader overview on the available treatments for ADHD , especially for safety issues , and contributes towards evidence gathering and clinical practice decisions .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare methylpheni date ( MPH ) and dexamphetamine ( DEX ) in a sample of children with attention deficit hyperactivity disorder ( ADHD ) . METHOD A total of 125 children with ADHD received both MPH ( 0.3 mg/kg twice daily ) and DEX ( 0.15 mg/kg twice daily ) for 2 weeks a double-blind , crossover study . Outcome measures were Conners ' Parent Rating Scale-Revised , Conners ' Teacher Rating Scale-Revised , a Parent Global Perceptions question naire , the Continuous Performance Test , and the Barkley Side Effects Rating Scale . RESULTS There were significant group mean improvements from baseline score on all measures for both stimulants . On the Conners ' Teacher Rating Scale-Revised , response was greater on MPH than DEX on the conduct problems and hyperactivity factors , as well as on the hyperactivity index . On the Conners ' Parent Rating Scale-Revised , anxiety was the only factor to differ significantly , in favor of MPH . Parents rated 73 % of subjects as globally improved on MPH and 69 % improved on DEX , compared with baseline . Overall , 46 % of parents chose MPH as the preferred drug , compared with 37 % who chose DEX . On the Continuous Performance Test , there was no difference in the number of correct responses or errors between the two drugs . CONCLUSIONS Most children with ADHD improve significantly on both MPH and DEX . There was a slight advantage to MPH on most measures Objective : Attention-deficit/hyperactivity disorder ( ADHD ) is the most common neurobehavioral disorder of childhood . Principal treatment options for ADHD today include the psychostimulants , mainly methylpheni date ( MPH ) . However , approximately 30 % to 50 % of children and adults with ADHD either do not respond to or do not tolerate treatment with stimulants . In this 8-week open-label , MPH-controlled , parallel group design study , we investigate the efficacy of reboxetine , a new selective norepinephrine reuptake inhibitor , in the treatment of boys with ADHD with a history of intolerance to MPH therapy . Method : Twenty-seven outpatient boys , aged 6 to 16 years , diagnosed with ADHD , participated in the study . Those with a history of intolerance to MPH therapy were assigned to treatment with reboxetine ( 2 - 8 mg/d ) , and the rest were assigned to treatment with MPH ( 10 - 20 mg/d ) as the control group . The primary outcome measure for this study was the change in rating scores on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition , ADHD Scale ( DAS ) that was assessed at baseline and at 8 weeks . Results : At the end of 8 weeks , both reboxetine and MPH treatment regimens result ed in significant improvement in ADHD symptoms . The change in the reduction in the total DAS score and the DAS subscale scores between the reboxetine group and the MPH group was not statistically significant in any of the scores . Conclusions : Although preliminary , results of this study indicate that the use of reboxetine , a new selective norepinephrine reuptake inhibitor , in the treatment of ADHD could increase treatment options available for children who have shown intolerance or who are unresponsive to MPH Twenty-two children with attention deficit-hyperactivity disorder underwent a double-blind , placebo-controlled , crossover evaluation of the efficacy of st and ard methylpheni date twice a day and comparable doses every morning of a sustained-release preparation of methylpheni date ( SR-20 Ritalin ) , a sustained-release form of dextroamphetamine ( Dexedrine Spansule ) , and pemoline . The children were participating in a summer treatment program in which they engaged in recreational and classroom activities . Dependent measures include evaluations of social behavior during group recreational activities , classroom performance , and performance on a continuous performance task . Results revealed generally equivalent and beneficial effects of all four medications . Dexedrine Spansule and pemoline tended to produce the most consistent effects and were recommended for 10 of the 15 children who were responders to medication . The continuous performance task results showed that all four medications had an effect within 2 hours of ingestion , and the effects lasted for 9 hours . The implication s of these results for the use of long-acting stimulant medication in children with attention deficit-hyperactivity disorder are discussed Objectives The aim of this study was to compare the efficacy and safety of the prodrug psychostimulant lisdexamfetamine dimesylate ( LDX ) and the non-stimulant noradrenergic compound atomoxetine ( ATX ) in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) who had previously responded inadequately to methylpheni date ( MPH ) . Methods This 9-week , head-to-head , r and omized , double-blind , active-controlled study ( SPD489 - 317 ; Clinical Trials.gov NCT01106430 ) enrolled patients ( aged 6–17 years ) with at least moderately symptomatic ADHD and an inadequate response to previous MPH therapy . Patients were r and omized ( 1:1 ) to an optimized daily dose of LDX ( 30 , 50 or 70 mg ) or ATX ( patients < 70 kg , 0.5–1.2 mg/kg with total daily dose not to exceed 1.4 mg/kg ; patients ≥70 kg , 40 , 80 or 100 mg ) . The primary efficacy outcome was time ( days ) to first clinical response . Clinical response was defined as a Clinical Global Impressions-Improvement ( CGI-I ) score of 1 ( very much improved ) or 2 ( much improved ) . Secondary efficacy outcomes included the proportion of responders at each study visit and the change from baseline in ADHD Rating Scale ( ADHD-RS-IV ) and CGI-Severity scores . Tolerability and safety were assessed by monitoring treatment-emergent adverse events ( TEAEs ) , height and weight , vital signs and electrocardiogram parameters . Endpoint was defined as the last post-baseline , on-treatment visit with a valid assessment . Results Of 267 patients r and omized ( LDX , n = 133 ; ATX , n = 134 ) , 200 ( 74.9 % ) completed the study . The median time to first clinical response [ 95 % confidence interval ( CI ) ] was significantly shorter for patients receiving LDX [ 12.0 days ( 8.0–16.0 ) ] than for those receiving ATX [ 21.0 days ( 15.0–23.0 ) ] ( p = 0.001 ) . By week 9 , 81.7 % ( 95 % CI 75.0–88.5 ) of patients receiving LDX had responded to treatment compared with 63.6 % ( 95 % CI 55.4–71.8 ) of those receiving ATX ( p = 0.001 ) . Also by week 9 , the difference between LDX and ATX in least-squares mean change from baseline ( 95 % CI ) was significant in favour of LDX for the ADHD-RS-IV total score [ −6.5 ( −9.3 to −3.6 ) ; p < 0.001 ; effect size 0.56 ] , inattentiveness subscale score [ −3.4 ( −4.9 to −1.8 ) ; p < 0.001 ; effect size 0.53 ] and the hyperactivity/impulsivity subscale score [ −3.2 ( −4.6 to −1.7 ) ; p < 0.001 ; effect size 0.53 ] . TEAEs were reported by 71.9 and 70.9 % of patients receiving LDX and ATX , respectively . At endpoint , both treatments were associated with mean ( st and ard deviation ) increases in systolic blood pressure [ LDX , + 0.7 mmHg ( 9.08 ) ; ATX , + 0.6 mmHg ( 7.96 ) ] , diastolic blood pressure [ LDX , + 0.1 mmHg ( 8.33 ) ; ATX , + 1.3 mmHg ( 8.24 ) ] and pulse rate [ LDX , + 3.6 bpm ( 10.49 ) ; ATX , + 3.7 bpm ( 10.75 ) ] , and decreases in weight [ LDX , −1.30 kg ( 1.806 ) ; ATX , −0.15 kg ( 1.434 ) ] . Conclusions LDX was associated with a faster and more robust treatment response than ATX in children and adolescents with at least moderately symptomatic ADHD who had previously responded inadequately to MPH . Both treatments displayed safety profiles consistent with findings from previous clinical trials This study evaluated the efficacy and safety of lisdexamfetamine dimesylate ( LDX ) compared with placebo in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) in Europe .  Osmotic-release oral system methylpheni date ( OROS-MPH ) was included as a reference arm . Patients ( 6 - 17 years old ) with a baseline ADHD Rating Scale version IV ( ADHD-RS-IV ) total score ≥ 28 were r and omized ( 1:1:1 ) to dose-optimized LDX  ( 30 , 50 , or 70 mg/day ) , OROS-MPH ( 18 , 36 , or 54 mg/day ) or placebo for 7 weeks . Primary and key secondary efficacy measures were the investigator-rated ADHD-RS-IV and the Clinical Global Impressions-Improvement ( CGI-I ) rating , respectively . Safety assessment s included treatment-emergent adverse events ( TEAEs ) , electrocardiograms , and vital signs . Of 336 patients r and omized , 196 completed the study . The difference between LDX and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -18.6 ( 95 % confidence interval [ CI ] : -21.5 to -15.7 ) ( p<0.001 ; effect size , 1.80 ) . The difference between OROS-MPH and placebo in least squares mean change in ADHD-RS-IV total score from baseline to endpoint was -13.0 ( 95 % CI : -15.9 to -10.2 ) ( p<0.001 ; effect size , 1.26 ) . The proportions ( 95 % CI ) of patients showing improvement ( CGI-I of 1 or 2 ) at endpoint were 78 % ( 70 - 86 ) , 14 % ( 8 - 21 ) , and 61 % ( 51 - 70 ) for LDX , placebo , and OROS-MPH . The most common TEAEs for LDX were decreased appetite , headache , and insomnia . Mean changes in vital signs were modest and consistent with the known profile of LDX . LDX was effective and generally well tolerated in children and adolescents with ADHD The efficacy and side effects of buspirone compared with methylpheni date ( MPH ) in the treatment of children with attention-deficit/hyperactivity disorder ( ADHD ) . A total of 34 children with ADHD as defined by DSM-IV-TR were r and omized to buspirone or methylpheni date dosed on weight-adjusted basis at buspirone ( 0.5 mg/kg/day ) and methylpheni date ( 0.3–1 mg/kg/day ) for a 6-week double-blind clinical trial . The principle measures of outcome were the teacher and parent ADHD Rating Scale . The side effects were assessed by the special side effect checklist of each drug . In both groups , the scores of teacher and parent ADHD Rating Scale significantly declined on the 6th week as compared to baseline ( p = 0.001 ) . These effects were observed in the subscales too . No significant differences were observed between the two protocol s on the total scores of parent and teacher ADHD Rating Scale , but methylpheni date was superior to buspirone in decreasing the symptoms of inattention . The side effects of buspirone were mild and rare in comparison with MPH . Buspirone has a favorable side-effects profile . It also has clinical ly and statistically significant impacts on improving the ADHD symptoms in children . These preliminary findings of the efficacy of buspirone in children with ADHD need large and cross-over studies Attention-deficit/hyperactivity disorder ( ADHD ) is associated with functional impairments in multiple domains of patients ’ lives . A secondary objective of this r and omized , active-controlled , head-to-head , double-blind , dose-optimized clinical trial was to compare the effects of lisdexamfetamine dimesylate ( LDX ) and atomoxetine ( ATX ) on functional impairment in children and adolescents with ADHD . Patients aged 6–17 years with an ADHD Rating Scale IV total score ≥28 and an inadequate response to methylpheni date treatment ( judged by investigators ) were r and omized ( 1:1 ) to once-daily LDX or ATX for 9 weeks . Parents/guardians completed the Weiss Functional Impairment Rating Scale-Parent Report ( WFIRS-P ) at baseline and at week 9 or early termination . p values were nominal and not corrected for multiple comparisons . Of 267 r and omized patients , 200 completed the study ( LDX 99 , ATX 101 ) . At baseline , mean 
    Output:
    