What We KnoW
Managing Medication or children and adolescents with ad/hd
, provides more detailed inormation aboutpsychosocial treatments that have been ound helpul orAD/HD.School success may require a range o interventions.Many children with AD/HD can be taught in the regularclassroom with minor adjustments to the environment.Some children will require additional assistance usingspecial education services. Tis service may be providedwithin the regular education classroom or may require aspecial placement outside o the regular classroom thatts the child’s unique learning needs.Te National Institute o Mental Health conducted amajor research study, called the Multimodal reatmentStudy o Children with AD/HD, involving 579 childrenwith AD/HD-combined type. Each child receivedone o our possible treatments over a 14-monthperiod—medication management, behavioral treatment,combination o the two, or usual community care. Teresults o this landmark study showed that children whowere treated with medication alone, which was careully managed and individually tailored, and children whoreceived both medication management and behavioraltreatment had the best outcomes with respect toimprovement o AD/HD symptoms.
Combination treatment provided the best results interms o the proportion o children showing excellentresponse regarding AD/HD and oppositional symptomsand in other areas o unctioning (e.g., parenting,academic outcomes).
Overall, those who receivedclosely monitored medical management had greaterimprovement in their AD/HD symptoms than childrenwho received either intensive behavioral treatmentwithout medication or community care with lesscareully monitored medication.For more inormation on evaluating treatments, pleaseread
What We Know #6: Complementary and Alternativereatments.
Tis act sheet provides checklists orspotting unproven remedies and evaluating mediareports on treatments.
THE rOlE Of MEDiCATiON
For most children with AD/HD, medication is anintegral part o treatment. It is not used to controlbehavior. Medication, which can only be prescribedby certain medical proessionals i needed, is usedto improve the symptoms o AD/HD so that theindividual can unction more eectively. Researchshows that children and adults who take medication orsymptoms o AD/HD usually attribute their successes tothemselves, not to the medication.
Psychostimulant compounds are the most widely usedmedications or the management o AD/HD symptoms.Psychostimulant medications were rst administeredto children with behavior and learning problems in1937. Despite their name, these medications do notwork by increasing stimulation o the person. Rather,they help important networks o nerve cells in thebrain to communicate more eectively with each other.Between 70-80 percent o children with AD/HD respondpositively to these medications. For some, the benetsare extraordinary; or others, medication is quite helpul;and or others, the results are more modest. Attentionspan, impulsivity, and on-task behavior oen improve,especially in structured environments. Some childrenalso demonstrate improvements in rustration tolerance,compliance, and even handwriting. Relationships withparents, peers and teachers may also improve.Medication does not cure AD/HD; when eective, italleviates AD/HD symptoms during the time it is active.Tus it is not like an antibiotic that may cure a bacterialinection, but more like eyeglasses that help to improve vision only during the time the eyeglasses are actually worn. Aer reviewing the scientic evidence, the AMAreported that “pharmacotherapy, particularly stimulants,has been extensively studied. Medication alone generally provides signicant short-term symptomatic andacademic improvement” and “the risk-benet ratio o stimulant treatment in AD/HD must be evaluated andmonitored on an ongoing basis in each case, but ingeneral is highly avorable.”
Common psychostimulant medications used in thetreatment o AD/HD include methylphenidate (Ritalin,Concerta, Metadate, Focalin), mixed salts o a single-entity amphetamine product (Adderall, Adderall XR),and dextroamphetamine (Dexedrine, Dextrostat).Methylphenidate, amphetamine, and mixed salts o amphetamine are now available as both short- and long-acting preparations. Short-acting preparations generally last approximately 4 hours; long-acting preparationsare more variable in duration—with some preparationslasting 6-8 hours, and newer preparations lasting 10-12