Your support helps us tell the story
From reproductive rights to climate change to big tech, The Independent is on the ground when the story is developing. Whether it’s investigating the finances of Elon Musk’s pro-Trump PAC or producing our latest documentary, ‘The A Word,’ which shines a light on American women fighting for reproductive rights, we know the importance of analyzing the facts of messaging. .
At such a critical moment in American history, we need reporters on the ground. Your donation allows us to continue sending journalists to tell both sides of the story.
The Independent is trusted by Americans across the political spectrum. And unlike many other quality news outlets, we choose not to block Americans from our reporting and analysis with a paywall. We believe that quality journalism should be available to everyone, and paid for by those who can afford it.
Your support makes a difference.
Talk therapy and brain stimulation are not as good as drugs for treating adults ADHDaccording to the largest study of its kind.
Stimulants and another drug — atomoxetine — appear to be the best treatment for treating the symptoms of the condition, the study suggests.
Attention deficit hyperactivity disorder (ADHD) used to be a condition usually associated with childhood, but health officials estimate that up to 4% of the adult population in the UK have ADHD.
A new study, published in The Lancet Psychiatry, pooled all studies on the treatment of ADHD in adults.
Our study represents the most comprehensive synthesis of evidence on the treatment of ADHD and should inform future guidelines.
Professor Samuele Cortese
Experts from University of Oxford and University of Southampton examined 113 trials involving more than 14,800 people.
They wanted to assess how well symptoms were controlled 12 weeks after a person started treatment based on physician and patient reports.
They found that stimulants are the only treatment for ADHD in adults that reduce symptoms, according to patient and physician ratings, and are well tolerated.
Another type of drug – atomoxetine – was found to be effective in reducing symptoms, according to doctors and patients, but appeared to be less well tolerated than placebo or a dummy drug.
Only doctors reported that talk therapy, “cognitive remediation,” mindfulness, “psychoeducation,” and transcranial direct current stimulation—or brain stimulation—were better than placebo.
But the authors say that ADHD medications are not well tolerated by everyone.
And they cautioned that their findings are based on averages, so for some people these treatments may be beneficial.
Lead researcher Dr Edoardo Ostinelli, from the University of Oxford, said: “We focused on average effect sizes, average performance of interventions and in particular pharmacological treatments.
“It may be natural that certain individuals prefer a treatment or non-pharmacological treatments, while others may not benefit from them.”
And commenters said the study did not examine the effects of drugs and other treatments when taken in combination.
They also said the study did not examine long-term treatment.
However, the review authors say their analysis is the “most comprehensive” available and should inform future treatment guidelines.
Dr Ostinelli added: “This network meta-analysis is a key step towards optimizing treatment strategies for ADHD in adults. By providing a comparative assessment of pharmacologic and non-pharmacologic options, it lays the foundation for more informed and patient-centered care.”
Professor Samuele Cortese, from the University of Southampton, added: “There is considerable variation in the way ADHD in adults is managed around the world.
“Our study represents the most comprehensive synthesis of evidence on the treatment of ADHD and should inform future guidelines.”
Andrea Bilbow, chief executive of the National Attention Deficit Information and Support Service, said the controversy surrounding ADHD drugs does not come from patients or the medical community.
“To me, the controversy around drugs doesn’t come from within the patient population or medicine, it comes from outside,” she said. ” (It’s) often people who may not understand the condition, they don’t understand the medication and they don’t understand the impact that medication can have on the lives of people with ADHD.”
On the rising rate of diagnosis in adults, she added: “Here we are today, with a huge number of adults who slipped through the net as children and so I think what we’re doing now is playing catch-up because there’s more awareness.
“And yes, social media has a role to play in raising awareness and adults suddenly realizing, ‘I think I’ve been fighting this my whole life and I should go and find out if this is what’s happening to me.’
“So I think that’s what explains the huge increase in diagnoses, not just in the UK, but around the world.”
Although some cases may be “misdiagnosed,” other experts said.
The NHS in England defines ADHD as “a condition that affects people’s behavior. People with ADHD can act restless, they can have trouble concentrating and they can act impulsively.”
He says adults with ADHD may find they have problems with: organization and time management; following instructions; focusing and completing tasks; coping with stress; feeling restless or impatient; impulsivity and risk taking. And some adults may have problems with relationships or social interaction.
Stimulants, a group of drugs that stimulate parts of the brain to improve concentration and attention and reduce impulsive and hyperactive behavior, include methylphenidate (such as Medikinet or Ritalin), lisdexamfetamine (such as Elvanse), and dexamfetamine (such as Amfexa).
Atomoxetine works differently than stimulants as a selective noradrenaline reuptake inhibitor, which increases the amount of noradrenaline in the brain which can help with concentration and help with impulse control.
The authors emphasized that their work, the largest “network meta-analysis” of ADHD treatment in adults, did not examine treatment in children.
A similar research project in children, published in 2017, found that medication was effective, but a combination of medication and a “behavioral intervention to train parents” was even more effective, they added.
Commenting on the research, Dr. Celso Arango from the University General Hospital Gregorio Maranon u Spainsaid: “The review highlights a clear lack of research on ADHD in adulthood, particularly with regard to medium-term (over 12 weeks) and long-term treatment outcomes, therefore the findings are only applicable to short-term treatment.
“The results suggest that pharmacological treatments are more effective than psychological or neurostimulation interventions alone compared to placebo, especially when evaluated by patients themselves.
“However, in terms of acceptability, atomoxetine and guanfacine showed less favorable profiles.
“One significant limitation is that a combined approach of pharmacological treatment plus psychological or other interventions has not been evaluated.”