Stimulant treatment prevents serious outcomes in ADHD patients

Washington: Early treatment with stimulants decreases the development of mood disorders, school problems, substance use disorders and other problems in children and young adults with attention-deficit hyperactivity disorder (ADHD), suggests a new study.

The study was published in the ‘Journal of Adolescent Health’.
“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, addictions, driving impairments and academic failure,” said Joseph Biederman, chief of the Pediatric Psychopharmacology and Adult ADHD Program at MGH and MassGeneral Hospital for Children.

The current study determined the number needed to treat (NNT) statistic, often used to show the effectiveness of an intervention.

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As the title indicates, NNT reflects the number of individuals receiving a medication or other treatment needed to prevent a specific unwanted outcome – the lower the NNT, the more effective the treatment.

The investigators analysed data from three separate studies.
Participants in the long-term studies averaged age 11 upon study entry and 20 at follow-up, and the current investigation focused only on those with ADHD. Participants in the driving study were ages 18 to 26.

The NNTs for the outcomes of interest were found to be quite low:
Three participants with ADHD needed to be treated to prevent one from repeating a grade or developing conduct disorder, anxiety disorders or oppositional-defiant disorder.

Four participants with ADHD needed to be treated to prevent one from developing major depression or experiencing an accident during the driving simulation.

Five participants with ADHD needed to be treated to prevent one from developing bipolar disorder, six to prevent one from smoking cigarettes, and ten to prevent one from developing a substance use disorder.

Adjustments for the sex of participants and several other factors did not change the impact of treatment on those outcomes, except that the protection against substance use disorders was stronger in younger participants.

“Now we have the evidence allowing us to say that stimulant treatment of ADHD prevents the development of several very serious functional outcomes,” said Biederman.

“However, the impact on other serious outcomes – such as post-traumatic stress disorder, traumatic brain injury, suicide risk and employment success – still needs to be investigated,” Biederman added.

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