HEALTHThink beyond drug therapy for treating ADHD: Study says medicate and modifyResults from a large trial comparing four different treatment modalities offer complicated answers.By Victoria Stagg Elliott, amednews staff. April 19, 2004. Treating children who struggle with attention-deficit/hyperactivity disorder poses a series of perplexing decisions for physicians and families. Choose medication and risk being criticized for taking the easy way out with a difficult child. Choose behavioral modification and run the risk of using expensive health resources that may not be as effective. Choose neither and the child could miss out on valuable educational opportunities. That's why much attention has been focused on the Multimodal Treatment Study of ADHD, a large randomized trial funded by the National Institute of Mental Health that sought to identify the optimal strategy for treating this disorder. When the Archives of General Psychiatry published the first round of findings in December 1999, the take-home message seemed clear. Closely monitored medication was superior to even the most expensive behavioral interventions and was certainly superior to the lower doses of medication combined with less intensive follow-up that most kids were getting. But the April Pediatrics offers two additional papers that made the best choice murky. "The appropriate use of medication is going to be one of the factors overall that really helps to optimize outcomes, but it's not going to be enough, and we don't know what the other factors are going to be," said Glen R. Elliott, MD, PhD, one of the study leaders and director of child and adolescent psychiatry at the University of California, San Francisco. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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