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".
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