ADHD: More questions than answers about how to treat

Some practitioners and researchers say drugs are by far the most effective treatment. Others argue that long-term drug use addresses symptoms only and does not provide
important tools to help people manage their inattentiveness. They say it’s more helpful to focus on behavioral interventions, nutrition, exercise and special
accommodations at school.

The American Psychiatric Association says there is no doubt that ADHD exists – and it estimates that 5 percent of U.S. children have the condition.

Science recognizes ADHD as involving brain development, although there is disagreement over what exactly happens in the brain to trigger ADHD symptoms. Barkley says there
is an inherited aspect, though he also says the condition is sometimes triggered by environmental factors such as exposure to smoke and alcohol before birth.

Whether children should be treated with medication sets off debate. “Some families say medications changed their child’s life for the better; others tell you horror stories,” said Ruth Hughes, former chief executive of Children and Adults with Attention-Deficit/Hyperactivity Disorder.

Advocacy groups such as CHADD suggest a mixed approach that may include medication but also entails the application of parenting skills, behavioral interventions and school support.

Studies have produced contradictory results on the effectiveness and safety of medications for ADHD. A 2014 article in the Journal of Health Economics, based on a
14-year study involving 8,643 children with ADHD, concluded that “expanding medication . . . had little positive benefit and may have had harmful effects, given the average way these drugs are used in the community.”

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