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ADHD in Children Health Center

Single Daily Dose of Adderall May Work as Well as Two Ritalin Doses for Children With ADHD

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If further studies produce the same results as those published in a recent issue of the Journal of the American Academy of Child and Adolescent Psychiatry,Adderall may become the first-choice ADHD medication for school-age children, researchers at the Cleveland Clinic Foundation ADHD Center suggest.

Researcher Michael J. Manos, PhD, director of the Cleveland center, and colleagues arranged for the 84 children in the study to receive either Ritalin or Adderall from their doctor, but neither the doctors nor the parents knew the dosage the children were receiving. Half of the children received Ritalin, and the other half received Adderall. The goal of the study was to compare the "effectiveness of Adderall given once in the morning with that of MPH [Ritalin] given in the morning and at noon...," write the researchers. Both medications were found effective for treating children with ADHD, based on teachers? and parents? ratings of the children?s behavior.

But some ADHD experts question the study?s conclusions. In an interview seeking independent assessment of the study, Charles Cunningham, PhD, a professor of psychology and behavioral neuroscience at McMaster University School of Medicine in Hamilton, Ontario, tells WebMD that "you really can?t draw any conclusions because this wasn't a randomized, controlled trial." Cunningham acknowledges that if the study could be repeated using more scientifically precise methods -- and if similar results were found -- it would be good news for parents of adolescent children with ADHD who take Ritalin. Usually, those children must take their second daily dose of medication during school, which can make monitoring of treatment difficult.

Another objective researcher also questioned the study?s merits -- for other reasons. Elisabeth Guthrie, MD, chief of the department of psychiatry at Blythedale Children's Hospital in Valhalla, N.Y., tells WebMD she believes the number of children in the study was too small to draw the conclusions reached by the researchers, and that she is "suspicious regarding Adderall because no drug on the market has had more PR than it has." Yet despite its marketing, Guthrie says, "I do think that clinically, it may end up having some advantages."

Both Manos and Guthrie hope to see further studies conducted in the use of Adderall as a possible substitute for Ritalin. Guthrie says that more studies are urgently needed "because the population taking [Adderall] has ballooned, while the scientific study of it has not kept up."

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