Treating ADHD: Drugs or Therapy Work
Study Shows Improvement in ADHD Symptoms With Medication or Behavior Therapy
WebMD News Archive
Medication and Behavior Therapy for ADHD
The latest follow-up study on which treatments worked best evaluated 485 of
the original 579 children when they were ages 10 to 13. The original study,
which continued for 14 months, evaluated four approaches: behavior therapy,
medication, medication plus behavior therapy, or routine community care. After
the 14 months, families could choose from treatments available in their
communities, and the original groups may have added or eliminated the
treatments they first took in the study.
By the three-year mark, the percentage of children taking ADHD medication
more than half the time had changed across the initial treatment groups, with
45% of the initial behavior therapy group, for instance, taking
medication. Overall, 45% to 71% of children were taking ADHD medication
at the three-year follow-up. But the medication was no longer associated with
better outcomes -- such as symptom control -- than the other approaches, as it
had been in the previous reports, issued at 14 months and two years.
In fact, all four groups had similar improvement in ADHD symptoms at the
three-year mark. On average, all still had some symptoms, but not in the severe
Some of that "lost ground" with medication "is due to less
intense treatment," says Jensen, director of The Reach Institute, a
nonprofit organization in New York focused on children's emotional and
behavioral health. "It's the only thing that changed [after the 14-month
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
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