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ADHD in Children Health Center

Medication More Effective Than Therapy Alone in Treating ADHD

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Dec. 14, 1999 (New York) -- Reporting data from the largest clinical trial comparing treatments for attention deficit hyperactivity disorder (ADHD), researchers said Tuesday that they have answered the "two major questions that have burdened the field" of ADHD. In the largest treatment study of children with ADHD, carefully managed medication was shown to be better than behavioral therapy in alleviating the symptoms of ADHD.

However, approximately two-thirds of children in the study had other psychological or social problems. These symptoms were best treated with a combination of well-monitored medication and behavioral therapy (summer day camps, school interventions, and family interventions).

"We really need to educate consumers about the need for a very comprehensive assessment and follow-up protocol," says Beth Kaplaneck, president-elect of the Washington-based group Children and Adults With Attention Deficit Hyperactivity Disorder. She spoke to WebMD following the announcement of the trial results. "We have to continue to demand that treatments be available that are multimodal."

In the study, which was conducted at six research sites in the U.S. and Canada, nearly 600 children between the ages of 7 and 10 with ADHD and other social problems were randomly assigned to one of four treatment approaches: a carefully managed medication approach; behavioral therapy alone; combination treatment; or routine community care.

While the researchers looked at four times as many boys as girls, they recruited the largest treatment group of girls to date, said Stephen P. Hinshaw, PhD, the study's principal investigator and a psychologist at the University of California, Berkeley. Children were treated for 14 months.

The study, which is published in the December issue of the Archives of General Psychiatry, was conducted in conjunction with Columbia University.

"A well-managed medical strategy may get you most of the way home," said the study's principal collaborator, Peter S. Jensen, MD, from the National Institutes of Mental Health. "Combination treatment may allow some children to be treated with less medicine, the study revealed."

According to Hinshaw, for children from "highly stressed families" -- for example, those with parents on public assistance -- combination therapy yields added benefit in enhancing social skills, peer interaction, and parent-child relations.

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