July 31, 2000
Volume XXXIII, No. 30



In Memoriam



UTHSC researcher finds ADHD drug shows promising results 


Children are to be seen and not heard. Sound familiar? Well, for children with attention deficit/hyperactivity disorder (ADHD), this couldn’t be further from the truth. Because of their disruptive behavior and boisterous play, which most times are uncontrollable, they’re both seen and heard.

With proper medication, children with ADHD can have typical routines. Yet deciding which medication is best can be difficult. Study results by Dr. Steven Pliszka, chief of child and adolescent psychiatry, help clarify matters.

His new study, published in the May issue of the Journal of the American Academy of Child and Adolescent Psychiatry, shows that Adderall (mixed salts of a single-entity amphetamine product), may have an advantage over Ritalin (methylphenidate) in the treatment of ADHD. It was significantly better at reducing inattention, oppositional behavior and other ADHD symptoms than the standard treatment—Ritalin.

"The higher response rate for Adderall is very encouraging," said Dr. Pliszka. "Our study suggests that Adderall can be the first option for treatment of ADHD."

In the study of 58 children with ADHD, 70 percent taking Adderall on a once-daily dosing schedule improved while only 15 percent of patients taking Ritalin on once-daily dosing improved. This dosing method is important because children can take their medication at home once a day and avoid taking it while school is in session.

Children in the study were given Adderall, Ritalin or placebo for three weeks. All groups started week one on a once-daily dosing regimen. If the children’s afternoon or evening behavior didn’t improve after week one, a midday or 4 p.m. dose was added for week two. Teachers rated morning and afternoon behaviors, while parents rated evening behaviors. Results showed that Adderall was significantly superior to Ritalin in reducing inattention and opposition at the doses studied.

According to teacher ratings, Adderall produced more improvements in inattentive and oppositional behaviors than Ritalin. Additionally, the psychiatrist-administered Clinical Global Impression Improvement scale, used to assess response to treatment, showed more children (90 percent) were found to be "very much improved" or "much improved" in ADHD symptom relief with Adderall when compared with 65 percent of the Ritalin group and 27 percent of the placebo group.

"Other drugs used to treat ADHD can require dosing three times a day, including a midday dose that typically must be given at school," said Dr. Pliszka, the lead investigator of the double-blind study funded by the makers of Adderall. "In our study, Adderall not only was more effective but also lasted longer, so a single dose given in the morning often covered the entire school day."

Taking medications during school can cause a stigma. Sometimes, teens are in charge of taking their own medication and may forget—or are too embarrassed—to take their midday dose.

"It’s important for children with ADHD to have effective treatment, because left untreated, ADHD can increase the risk of low self-esteem [that can lead to] social and academic failure," said Dr. Pliszka.