In the long run, skills are as good as pills for attention deficit hyperactivity disorder

Joseph M Rey
Med J Aust 2008; 188 (3): . || doi: 10.5694/j.1326-5377.2008.tb01553.x
Published online: 4 February 2008

The need for stimulant treatment must be assessed regularly

In a United States legal action in 2000 about educational neglect, Albany County judge G E Maney ordered the parents to resume administering methylphenidate to 7-year-old Kyle Carroll.1 At the time, this controversial ruling was understandable, because controlled trials of stimulant treatment (dexamphetamine and methylphenidate) for attention deficit hyperactivity disorder (ADHD) had consistently shown that stimulants reduce ADHD symptoms. The catch is that trials have examined short-term effectiveness (usually over less than 6 months), while ADHD is a chronic condition.

  • Department of Psychological Medicine, University of Sydney, Sydney, NSW.


  • 1. Caher J. Ritalin case puts parents, courts on collision course. N Y Law J 2000; 17 Aug.
  • 2. MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999; 56: 1073-1086.
  • 3. Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics 2001; 108: 1033-1044.
  • 4. Jensen PS, Arnold LE, Swanson JM, et al. 3-year follow-up of the NIMH MTA Study. J Am Acad Child Adolesc Psychiatry 2007; 46: 989-1002.
  • 5. Molina BSG, Flory K, Hinshaw SP, et al. Delinquent behavior and emerging substance use in the MTA at 36 months: prevalence, course, and treatment effects. J Am Acad Child Adolesc Psychiatry 2007; 46: 1028-1040.
  • 6. Taylor E. Development of clinical services for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999; 56: 1097-1099.
  • 7. Costello EJ, Mustillo S, Erkanli A, et al. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003; 60: 837-844.
  • 8. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006; 36: 159-165.
  • 9. Shaw P, Eckstrand K, Sharp W, et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci USA 2007; 104: 19649-19654.
  • 10. Swanson JM, Elliott GR, Greenhill LL, et al. Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. J Am Acad Child Adolesc Psychiatry 2007; 46: 1015-1027.


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