Return to ADDvisor Volume 3 2001 Index

Number 23 December 1, 2001

In this issue:

1. Medication and ADHD

2. Resource - The Brown University Child and Adolescent Behavior Letter

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MEDICATION AND ADHD

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In the December issue of Monitor On Psychology, the monthly magazine of the American Psychological Association, there appeared an article about medication and ADHD. It summarized the presentations made about ADHD at the August 2001 APA convention in San Francisco. There were presentations by Peter Jensen, MD and William Pelham, PhD; Gretchen LeFever, PhD; Lawrence Diller, MD, Russell Barkley, PhD, and Charles Cunningham, PhD.

The subject was the controversy surrounding medicating children with ADHD. LeFever’s research into the prevalence of medication use for ADHD centered in her home state of Virginia. She cited two school districts that have medication rates two to three times higher than the national average.

Dr. Diller also suggested that medication rates are too high. He admitted that Ritalin works but parenting and school interventions need to be considered.

Jensen and Pelham, two of the investigators in the MTA study, stated that behavioral therapy alone did not work as effectively as medication to reduce the symptoms of ADHD. They also said that the combination of behavioral intervention and medication was more successful in treating "domains of functional impairment" such as aggression, social skills and defiance.

Jensen and Pelham reported that the one year followup of the MTA study found that those treated with the combination of behavior intervention and medication had "normalized" the behavior that set them apart from other children. They reported that in the medication only group of the study, there were more medication "dropouts" and more dissatisfaction with the treatment than the group who received the combined treatment.

Barkley suggested that rather than look at the medication question, it would be better to address the question as to why our country does not invest more in early identification and intervention. He also would like to see wider access to treatment.

ADHD is largely an inherited disorder with neurological underpinnings that responds positively to medication. Barkley feels that as many as 50% of children are not identified and treated for ADHD so the real question is why is this the case.

Pelham added that treatment needs to be individualized for each patient and that parents should be informed of the choices available. Wider treatment options will help to normalize the functioning of children with ADHD.

In summary, it appears that while medication is a proven intervention that reduces the symptoms of ADHD, behavioral interventions are necessary to improve an ADHD child’s ability to function in their social world and to improve medication compliance over the long term.

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RESOURCE - THE BROWN UNIVERSITY CHILD AND ADOLESCENT BEHAVIOR LETTER

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The Brown University Child and Adolescent Behavior Letter is a very informative monthly report on the problems of children and adolescents growing up. For subscription information, call 800-333-7771 (in the US only).