Medication More Effective Than Therapy Alone in Treating ADHD
The medication treatment arm of the study was far more intensive than that found in conventional practice, stressed Hinshaw. In the first month of medical treatment, a far more aggressive effort was made to find an optimal dose of medication (between 32 and 38 mg per day). All children were put on three-times-a-day dosing. After the first month, monthly half-hour visits with the family were held to address medication and other ADHD-related problems.
Children who came in frequently had a better response than those seen less frequently in the community, said Hinshaw, who added that the more frequent interaction appears to bolster quality of care.
And while behavioral therapy alone did not match the effectiveness of well-monitored medication, investigators stressed that behavioral therapies evaluated in the study did improve social skills, parent-child relations, and school performance, and reduced anxiety.
Researchers took pains to stress that treatments should not be of the 'one-size-fits-all' variety and that careful diagnostic evaluation is needed to assess related problems.
The study suggested that the 15-minute medication check done once every four months in community practice is not optimal. "Only by families and consumers pressing for better care" will this standard change, said Jensen.
- In the largest trial to date of children with ADHD, carefully managed medication was a more effective treatment than behavioral therapy.
- Behavioral therapy used in combination with medication was the best treatment for two-thirds of children in the trial who had other psychological or social problems in addition to ADHD.
- The medication treatment for the study was much more intensive than what is used in conventional practice.