Drugs are Still Not the Answer for ADHD
Research Shows Medication does not Have Long Term Benefits
© Zoe Langley, May 30, 2009
The results of a federally sponsored research do not support claims that stimulants such as Ritalin are necessary or superior to behavioral and other therapies for ADHD.
The research, called the MTA, was funded by the National Institute of Mental Health (NIMH). It was the largest study ever done to compare different types of treatment for ADHD. Many researchers and six universities were involved in the project, which started in the 1990s.
The initial study included 579 children who were assigned to one of three types of groups for fourteen months of intensive treatment:
- Behavior therapy
- Combination of medication and behavior therapy
When the results were evaluated at 14 months, the children remaining in the study stayed in their original groups or went into a fourth group receiving treatment chosen by their parents. They were followed up at two years, three years, and eight years.
Early Study Results Glamorized
The results of the fourteen month study were evaluated in 1999. The researchers concluded receiving medication only or medication combined with behavioral therapy were more effective as treatments for ADHD than those receiving only behavioral therapy.
Those results were quickly picked up by the media and drug promoters as proof that Ritalin and other stimulants were the best or only effective treatment for ADHD. Drug sales increased, and millions of children were prescribed stimulants, some forced to take them by school and other authorities. Professionals and parents were led to believe that Ritalin and other stimulants are the only proven treatment for ADHD symptoms despite a lot of evidence that behavior therapy works just as well as drugs.
Short term treatments give short term results
A small study conducted twenty-years earlier had already indicated that the initial improvement seen with medication in the MTA results would be short-lived. Charles and colleagues(1979) found that medication should be used only as a short-term treatment and was not effective for long term therapy.
According to a report from the NIMH, "About half the initial benefits of the intensive medication management and combination treatments dissipated by the first follow-up, which was two years after the trial began."
In 2007, another MTA follow-up study found the early benefits of both medication alone and medication combined with behavior therapy did not last. This raised further questions about the need and value of drug therapy for long term treatment.
Eight Year Follow-up
The results of the MTA eight-year follow-up again finds drugs are not more effective than other treatments. Kids who were still taking drugs were doing no better than those who had stopped using them. None of the intensive treatments used initially was linked to a better outcome.
Alternatives to Drug Treatment
The question "to medicate or use alternatives" has gotten easier to answer. Drugs may have a place for short-term use, but behavioral therapies are equally effective for treating ADHD. The latest follow-up on the MTA may leave professionals and parents more confident about exploring behavioral and other therapies for ADHD treatment.
Charles L, et al; Long-term use and discontinuation of methylphenidate With Hyperactive Children; Dev Med Child Neurol. 1979 Dec;21 (6):758-64.
National Institute of Mental Health; Short-term Intensive Treatment Not Likely to Improve Long-term Outcomes of Children With ADHD; Science Update Mar 26,2009
Shute, Nancy; ADHD Drugs Don't Help Children Long Term; U.S. News & World Report Online; Mar 27, 2009
Shute, Nancy; ADHD Medication: Can Your Child do Without? Behavioral therapy for ADHD-and parent retraining too-can be good alternatives to medication; U.S. News & World Report Online; Jan 14, 2009
A Healthy Place: ADHD Homepage: Information, support and resources
This article is intended to provide information only and should not be construed as offering medical advice. If you have a medical condition requiring attention, please seek the help of qualified medical professionals.
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