An Australian study has revealed a "significant lack of effect" of
conventional drugs used to treat ADHD, a finding that surprised at
least one of its researchers.

Professor Lou Landau
was co-author of the WA-based research which investigated the
effectiveness of drugs now widely used to treat Attention Deficit
Hyperactivity Disorder (ADHD) in children.

principal medical adviser to the West Australian Department of Health
said he did not expect such a strongly negative result.

"Yes, we weren't anticipating that significant effect," Prof Landau told AAP on Wednesday.

"… or the significant lack of effect of the medication."

Landau and fellow researchers pulled data from the nation's long-term
Raine Study to assess the health, and other, outcomes of 131 children
with ADHD among more than 2,800 Australian families.

showed how those using conventional ADHD drugs, such as Ritalin and
dexamphetamine, had significantly poorer educational outcomes than
children with ADHD not using the stimulants.

drugs were also linked to a "trend toward slightly higher depression
scores", the study found, along with a potentially long-term risk
factor for heart disease.

Children using ADHD drugs
were found to have elevated diastolic blood pressure – which is the
minimum pressure in the arteries when the heart is at rest.

Landau said this side effect was known though it was previously thought
to occur in children "while on the medication and it drops down when
you stop".

"That was the difference that this study showed … it was having an effect on the blood vessels that persisted," he said.

it came to educational performance, children on ADHD drugs were shown
to be significantly worse off than those with unmedicated or no longer
medicated ADHD.

This effect was present even after
researchers accounted for the fact that ADHD children with the worst
symptoms were most likely to be prescribed the drugs.

children with ADHD, ever receiving stimulant medication was found to
increase the odds of being identified as performing below age-level by
a classroom teacher by a factor of 10.5 times," the study found.

Overall, there was "little long-term benefit of stimulant medication" for ADHD children, the study concluded.

had roughly the same behavioural and attention problems "regardless of
medication use", it said, though "where an effect was noticed, this was
in the direction of symptoms worsening with the use of ADHD medication".

results of the population-based study would need to be confirmed with
randomised trial, Prof Landau said, but it did show how parents should
not automatically opt for a drug-based treatment for their ADHD child.

"That management is a partnership between the parents, teachers and their doctor," Prof Landau said.

has to make sure (ADHD children) are healthy, have educational support
and social support and then, in some cases, there may be a role for

"But before making that decision one
has to consider the potential short-term benefits against potential
risks and possibly not a major change in the long term."

Landau is a co-author of the "Raine ADHD Study: Long-term outcomes
associated with stimulant medication in the treatment of ADHD in
children" report.

The report was released by the WA government on Wednesday.


Source: Sydney Morning Herald –