Medical Edge Newspaper Column

Long-Term Study Gives Passing Marks To ADHD Meds

June 18, 2006
DEAR MAYO CLINIC:
My 10-year-old daughter has been taking Adderall XR daily for just over a year, for attention deficit hyperactivity disorder. She's doing much better at school, and there are no obvious side effects. Is the medication effective long term? How or when should I consider stopping the medication? -- Lakeville, Minn.

ANSWER:
Recently, Mayo Clinic published research that helps to answer your questions on the long-term use of stimulant medication to treat ADHD, and the news is encouraging.

ADHD makes it difficult for children to control their behavior and/or pay attention. The U.S. Food and Drug Administration estimates that 2.5 million children with ADHD take stimulant medications such as methylphenidate (Ritalin, Concerta), amphetamines (Adderall) and dextroamphetamine (Dexedrine).

It's well documented that stimulant medication helps about 70 percent of children with attention deficit and hyperactivity disorder. But nearly all of these studies have been carefully controlled, short clinical trials. Previously, the most comprehensive published study tracked children for just two years.

The new research tracked children throughout their childhoods. Mayo Clinic researchers reviewed medical and school records of all children born in Rochester, Minn., from 1976 to 1982 and identified 379 children diagnosed with ADHD. Children with ADHD were tracked from birth to almost age 18.

We found that 73 percent of all treatment episodes with stimulant medications were associated with a favorable response. The results were similar for girls and boys, and for children who were both inattentive and hyperactive. This study suggests that stimulant medications work as well in community settings as they do in structured clinical trials.

Your child should have regular visits with her pediatrician, typically every four to six months, to evaluate the effectiveness of the treatment and to monitor for possible side effects. This would include checking height, weight, blood pressure and heart rate.

Current research suggests that the majority of children with ADHD will continue to have symptoms that persist into adulthood. You, your child's pediatrician and your child's teachers will need to observe your daughter to determine if her symptoms persist, and if medication treatment is still necessary. In some instances, this can only be determined by discontinuing the medication for a short period of time.

-- William Barbaresi, M.D., Developmental and Behavioral Pediatrics, Mayo Clinic, Rochester, Minn.