Mapping the applications and methodological characteristics of the TreeScan method in pharmacovigilance and beyond: a scoping review of 44 studies.

In their recent literature review, “The efficacy and safety of antidepressants as alternative treatment of attention-deficit/hyperactivity disorder in pediatric populations,” Hilo and colleagues describe the available literature on antidepressant use in pediatric attention-deficit/hyperactivity disorder (ADHD), but appear to have methodologic inconsistencies. First, the inclusion criteria state “Only trials comparing antidepressants against first-line stimulants or placebo were included.” However, 25% of their included studies (Table 2) did not have a direct comparator, limiting internal validity and clinical inference. Additionally, the authors list 4 venlafaxine studies, but at least 5 are published. The missing article is a 6-week, double-blind study comparing venlafaxine vs methylphenidate in children with ADHD. In summary, venlafaxine produced statistically significant reductions in ADHD Rating Scale IV scores, with response rates of 33% (parent-rated) and 44% (teacher-rated), reflecting modest to moderate clinical improvement. In comparison, methylphenidate demonstrated a higher response rate of 95% within 2 weeks ( < 0.001) across both parent and teacher scales, indicating faster and greater symptom control, reinforcing stimulants as first-line therapy. We ask the authors to clarify their study inclusion and exclusion criteria and edit the results, as needed.