Landmark ADHD study backing drugs over counseling questioned

ADHD symptoms stable in early life despite meds
ADHD symptoms stable in early life despite meds

HealthDay News -- Many children with attention-deficit hyperactivity disorder (ADHD) may have missed out on valuable counseling because of a widely touted study that concluded stimulants such as Ritalin and Adderall were more effective for treating the disorder than medication plus behavioral therapies, experts say.

That 20-year-old study, funded with $11 million from the U.S. National Institute of Mental Health, involved nearly 600 children with ADHD aged 7 to 9 years. Participants received one of four treatments for more than a year: medication alone, behavioral therapy alone, a combination of both treatments or nothing in addition to their current treatment. More than a dozen experts were enlisted to determine the best ADHD treatment.

Originally published in 1999, the NIMH study concluded that the medications outperformed a combination of stimulants plus skills-training therapy or therapy alone as a long-term treatment.

But now, experts, including some of the original study's authors, think that relying on such a narrow avenue of treatment may deprive children, their families and their teachers of effective strategies for coping with ADHD, The New York Times reported.

When study participants were followed into adulthood, the findings looked less conclusive. Use of any treatment "does not predict functioning six to eight years later," a follow-up paper from the study determined, the Times reported.

Professionals worry that the original findings have overshadowed the long-term benefits of school- and family-based skills programs. The original findings also gave pharmaceutical companies a significant marketing tool -- now more than two-thirds of American children with ADHD take medication for the condition.

Insurers have also used the study to deny coverage of psychosocial therapy, which costs more than daily medication but may deliver longer-lasting benefits, according to the Times. An insured family might pay $200 a year for stimulants, while individual or family therapy can be time-consuming and expensive, reaching $1,000 or more.

"I hope it didn't do irreparable damage," study coauthor Lily Hechtman, MD, of McGill University in Montreal, told the Times. "The people who pay the price in the end [are] the kids. That's the biggest tragedy in all of this."

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