Treatment with stimulant medication offers strong protection against a slate of serious functional outcomes in youth with attention-deficit/hyperactivity disorder (ADHD), suggests a study published online in the Journal of Adolescent Health.
Researchers analyzed data from 3 studies to calculate number-needed-to-treat statistics on reducing the development of mood disorders, school problems, and other functional complications associated with ADHD. Two were 10-year studies that included children with and without ADHD, and one was a randomized trial that looked at the effect of lisdexamfetamine on driving performance.
The researchers found number-needed-to-treat statistics which they described as “very low.” Specifically, to prevent one participant with ADHD from:
• repeating an academic grade or developing conduct disorder, anxiety disorders, or oppositional-defiant disorder, the number needed to treat was 3;
• developing major depression or experiencing an accident during a driving simulation, the number needed to treat was 4;
• developing bipolar disorder, the number needed to treat was 5;
• smoking cigarettes, the number needed to treat was 6; and
• developing a substance use disorder, the number needed to treat was 10.
When researchers adjusted for participant sex or other factors, the protective impact of treatment on most outcomes remained the same. The exception was protection against substance use disorders, which was strongest in younger participants.
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“Now we have the evidence allowing us to say that stimulant treatment of ADHD prevents the development of several very serious functional outcomes,” said researcher Joseph Biederman, MD, chief of the pediatric psychopharmacology and adult ADHD program at Massachusetts General Hospital and MassGeneral Hospital for Children in Boston.
“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 J, DiSalvo M, Fried R, Woodworth KY, Biederman I, Faraone SV. Quantifying the protective effects of stimulants on functional outcomes in attention-deficit/hyperactivity disorder: a focus on number needed to treat statistic and sex effects. Journal of Adolescent Health. 2019 July 3;[Epub ahead of print].