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This \u201cLong-term Medication for ADHD (LMA) trial\u201d was a prospective observational 2-year trial in children and adolescents aged 6\u201318\u00a0years (extension of 1-year trial). Participants met criteria for DSM-5 ADHD (inattentive or combined), with complex comorbidities; autism spectrum disorder (31%), autistic traits (24%), oppositional symptoms (59%), anxiety (32%), dyslexia\/language disorder (16%), borderline intellectual functioning (17%). Medication was individually tailored and followed-up at clinical visits (1, 2, 3, 6, 12, 18, 24\u00a0months). Primary outcome: Clinical Global Impression-Severity and Improvement scales (CGI-S, CGI-I). Secondary outcomes: Investigator-rated ADHD-Rating Scale, Weiss Functional Impairment Rating Scale-Parent report<jats:italic>\u00a0(<\/jats:italic>WFIRS-P; Family, School Learning and Behavior, Life Skills, Self-Concept, Social Activities, and Risky Activities domains), comorbidity symptoms and adverse events (AEs). One hundred twenty-eight participants were enrolled (1-year trial only<jats:italic>n<\/jats:italic>\u2009=\u200927, LMA trial<jats:italic>n<\/jats:italic>\u2009=\u2009101). Of these 29 (23%) discontinued, mainly due to AEs (<jats:italic>n<\/jats:italic>\u2009=\u20097), moving (<jats:italic>n<\/jats:italic>\u2009=\u20097), or no longer needing medication (<jats:italic>n<\/jats:italic>\u2009=\u20096). Main AEs were poor appetite, low mood, anxiety, irritability, fatigue. Improvements from baseline to 2\u00a0years were large in CGI-S (effect size (ES) 2.28), ADHD-RS (ES 2.06), and moderate to large in WFIRS-P (ES total 0.73, learning 0.4, family 0.67). Overall, the trial showed robust and sustained improvements in ADHD symptom severity and daily functioning over a period of 2\u00a0years of ADHD medication in children and adolescents with ADHD and complex comorbidities. Most AEs were mild. Comorbidity symptoms were improved after 1\u00a0year, particularly oppositional\u00a0symptoms, depression, and anxiety.<\/jats:p>","DOI":"10.1007\/s00406-023-01744-1","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T18:02:03Z","timestamp":1706378523000},"page":"879-890","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long-term medication for ADHD (LMA) trial: 2-year prospective observational study in children and adolescents. 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All other authors report no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The Gothenburg ethical committee approved the original 1-year trial (no. 897-13), and an amendment for the 2-year extension (LMA trial, no. 725-16). Written informed consent\/assent was obtained from the children and both parents after the nature of the procedures had been fully explained. The Swedish Medical Products Agency was informed about the trial, and it was registered in ClinicalTrials.gov, identifier NCT03250013.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}