The front page of this morning’s *Washington Times* includes an article:
“Debate Over Drugs For ADHD Reignites; Long-Term Benefit For Children at
Issue” by Shankar Vedantam.

Here are some excerpts:

[begin excerpts]

New data from a large federal study have reignited a debate over the
effectiveness of long-term drug treatment of children with hyperactivity
or attention-deficit disorder, and have drawn accusations that some
members of the research team have sought to play down evidence that
medications do little good beyond 24 months.

The study also indicated that long-term use of the drugs can stunt
children’s growth.

The latest data paint a very different picture than the study’s positive
initial results, reported in 1999.

One principal scientist in the study, psychologist William Pelham, said
that the most obvious interpretation of the data is that the medications
are useful in the short term but ineffective over longer periods but
added that his colleagues had repeatedly sought to explain away evidence
that challenged the long-term usefulness of medication.

When their explanations failed to hold up, they reached for new ones,
Pelham said.

“The stance the group took in the first paper was so strong that the
people are embarrassed to say they were wrong and we led the whole field
astray,” said Pelham, of the State University of New York at Buffalo.

Pelham said the drugs, including Adderall and Concerta, are among the
medications most frequently prescribed for American children, adding:
“If 5 percent of families in the country are giving a medication to
their children, and they don’t realize it does not have long-term
benefits but might have long-term risks, why should they not be told?”

The disagreement has produced a range of views among the researchers
about how to accurately present the results to the public.


In August 2007, the MTA researchers reported the first follow-up data,
which by then no longer showed differences in behavior between children
who were medicated and those who were not.

But the data did show that children who took the drugs for 36 months
were about an inch shorter and six pounds lighter than those who did not.

A news release issued by the National Institute of Mental Health (NIMH)
at the time, however, presented the results in a more favorable light.

The release, dated July 20, 2007, was titled “Improvement Following ADHD
Treatment Sustained in Most Children.”


The release noted that the initial advantages of drug treatment were no
longer evident, but it quoted Jensen as saying this did not mean that
long-term drug therapy was ineffective.

Jensen said, “We were struck by the remarkable improvement in symptoms
and functioning across all treatment groups.”

And rather than saying the growth of children on medication was stunted,
the release said children who were not on medication “grew somewhat larger.”


Pelham, who has conducted many drug therapy studies, said the drugs have
a valuable role: They buy parents and clinicians time to teach
youngsters behavioral strategies to combat inattention and
hyperactivity. Over the long term, he said, parents need to rely on
those skills.

A yet-to-be-published study, Pelham added, found that 95 percent of
parents who were told by clinicians to first try behavioral
interventions for ADHD did so.

When parents were given a prescription for a drug and then told to
enroll their children in behavioral intervention programs, 75 percent
did not seek out the behavioral approaches.

[end excerpts]

Courtesy of Ken Pope

The article is online at: