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ADHD

18 August 2019

Study shows stimulant treatment can prevent serious outcomes of ADHD

A study has revealed that treatments with stimulant medications in children can be linked to a lower risk of functional complications.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological syndrome found in children and adults. Symptoms include poor concentration and organisational skills, being distracted easily having a low tolerance for boredom and frustration and impulsivity.

A new study looked at the extent to which stimulant treatment reduces the development of mood and conduct disorder, substance use, difficulties at school and other problems. 

Medication or placebo

The study, published in the Journal of Adolescent Health was led by Massachusetts General Hospital. It analysed data from previous studies in order to calculate the "number needed to treat" (NNT) to prevent specific outcomes.

Two of the studies were long term studies of children with and without ADHD, one of boys and one of girls who were treated with stimulants and some who were not. The third study was a randomized, double blind study of young adults with ADHD that compared their initial performance on a driving simulation with their performance after six weeks of treatment with a stimulant medication or a placebo.

The ages of the children in the long-term study averaged from 11 upwards when they entered the study and 20 at the follow up. The current study only focused on participants with ADHD and participants in the driving study who were between the ages of 18 to 26.

The NNT outcomes of the study were found to be relatively low:

  • 3 participants with ADHD needed to be treated in order to prevent one from repeating a grade or developing conduct disorder, anxiety disorders or oppositional-defiant disorder.
  • 4 participants with ADHD needed to be treated to prevent one from developing major depression or experiencing an accident during the driving simulation.
  • 5 participants with ADHD needed to be treated to prevent one from developing bipolar disorder, 6 to prevent one from smoking cigarettes and 10 to prevent one from developing a substance use disorder.

Joseph Biederman, MD, chief of the Paediatric Psychopharmacology and Adult ADHD Program at MGH and MassGeneral Hospital for Children said, "Our study documents that early treatment with stimulant medication has very strong protective effects against the development of serious, ADHD-associated functional complications like mood and anxiety disorders, conduct and oppositional-defiant disorder". He added that, "In quantifying the improvement seen with stimulant treatment, it measures its potency in mitigating specific functional outcomes."

Biederman also said that "the impact of serious outcomes – such as post-traumatic stress disorder, traumatic brain injury, suicide risk and employment success – still needs to be investigated". 

Image credit: iStock

 

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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