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ADHD Study Stirs Controversy

Mar 27, 2009 | Parker Waichman LLP

The safety and effectiveness of medications used to treat attention-deficit hyperactivity disorder (ADHD) are being questioned with the release of new study data that shows such drugs to be ineffective - and possibly harmful - in the long term.  According to The Washington Post, the findings are also raising questions about the conduct of some involved in the research, because they are very different than initial findings that were released in 1999.

The study, known as the Multimodal Treatment Study of Children (MTA), was designed to test whether children diagnosed with ADHD do better when treated with drugs, with drugs plus talk therapy, with talk therapy alone or with routine medical care alone.  

According to the Washington Post, the initial results published over a decade ago  showed clearly that those treated with medication did much better than those who got only talk therapy or routine care.  Drug makers, of course, took advantage of the findings, and used the initial results in promotional materials. And according to The Post, the study's initial findings resulted in treatment being skewed in direction of medication.

The first follow-up results were issued in 2007.  They no longer showed differences in behavior between children who were medicated and those who were not.  What's worse,  the study also showed that children on drugs for three years were shorter and lighter than their non-medicated counterparts.

But according to The Post, those results were presented in a more positive light in a July 2007 news release issued by the National Institute of Mental Health.  And instead of saying that the growth of medicated kids was stunted, the release said that non-medicated children “grew somewhat larger.”

The positive presentation of the MTA study most likely encouraged the increased use of ADHD medications.  In 2004, physicians wrote 28.3 million prescriptions for ADHD drugs; last year, they wrote 39.5 million, The Post said.

According to The Washington Post, over the past several years, the study continued to show little difference between medicated and non-medicated children.  Some of data were published online Thursday in the Journal of the American Academy of Child and Adolescent Psychiatry.  

One principal scientist in the study, psychologist William Pelham, told the Post  that the most obvious interpretation of the data is that the medications are useful in the short term but ineffective over longer periods.  But Pelham claims his colleagues had repeatedly sought to explain away evidence that challenged the long-term usefulness of medication, the Post 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," Pelham, of the State University of New York at Buffalo, told the Post. "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?"

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