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Treating ADHD: Drugs or Therapy Work

Study Shows Improvement in ADHD Symptoms With Medication or Behavior Therapy

ADHD Medications Wear Off

In a second report, the researchers tried to figure out why the ADHD medication's effect seems to wear off at the three-year mark, at least for some children. "We analyzed symptoms based on whether or not they were on medication, regardless of what [study] group they were in," says James M. Swanson, PhD, professor of pediatrics at the University of California, Irvine, and a co-author on all four papers.

Still, he tells WebMD, they found at the three-year mark that "all the kids looked better, but the ones taking medication were no better [than the others]."

However, the researchers did find that for a subset of the children, the medication effect seems to kick in at the three-year mark, Swanson says. "These are the kids who initially didn't show a good response [to medication]. They only got a little better the first year but continued to get better over three years."

Of all the children studied, he says, about 34% of them fall into this category, those who do seem to be helped long-term by the drugs. While it's not possible to describe exactly who these children are, Swanson says they tend to be more likely to have other conduct disorders along with the ADHD diagnosis.

ADHD and Risk-Taking Behavior

Another report found that children with ADHD have an increased risk of delinquent behavior, such as stealing or starting fights at school, as well as substance use, such as experimenting with tobacco, alcohol, or illicit drugs. "I don't want people to think these kids are addicts by middle school," says Brooke S.G. Molina, PhD, associate professor of psychiatry and psychology at the University of Pittsburgh and an author of that report. But they were more likely than other children to experiment, she says.

Her team compared delinquency and substance use among 487 children from the MTA study and 272 control students not diagnosed with ADHD. While 27.1% of the ADHD children exhibited delinquent behavior, 7.4% of the comparison group did. Substance use was reported by 17.4% of the ADHD children but 7.8% of the comparison group.

Study Limitations

The study has many limitations, the authors note. The three-year follow-up portion of the study looking at the four treatment approaches did not have an untreated group for comparison. After the first 14 months of the study, children were free to pick and choose among treatments, so the original four treatment groups later received a mix of therapies. Children who took medication for the first 14 months, for instance, may have stopped taking it later.

Some ADHD symptoms may actually subside naturally over time, without treatment, some other research suggests. Experts call this the "clock-setting cure."

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