Although there are no published studies that address the sequential efficacy of ADHD medication as their primary objective, such studies as the present one can be informative. Subgroup analyses in this study highlight the importance of considering the medication history of children and adolescents with ADHD to help guide clinical intervention for individual patients, and ultimately algorithm development. As has been previously reported, secondary analyses of the RCT indirectly favored GXR versus ATX in a prespecified comparison of the change from baseline in ADHD-RS-IV total score at endpoint.19 Results from the prespecified analyses reported here suggest that the efficacy observed in participants treated with GXR but not ATX may be some- what explained by the prior MPH-treated cohort.

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