A clinical review of outcomes of the Multimodal treatment study of children with attention-deficit/hyperactivity disorder (MTA)

Murray, Desiree W.; Arnold, L. Eugene; Swanson, Jim; Wells, Karen C.; Burns, Karen E. A.; Jensen, Peter S.; Hechtman, Lily; Paykina, Natalya; Legato, Lauren J.; Strauss, Tara

doi:10.1007/s12618-009-0007-2

Cited by 11 publications

(16 citation statements)

References 44 publications

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“…However, it was noted that the children in the MTA medication treatment arms received larger doses of medication for a longer period of time and medication management by a clinical pharmacist occurred monthly, compared to the communitytreated group where this did not occur. 11,52,53 In the 8-year follow-up study, there appears to be a loss of sustained effects of medication after 2 years. Since the long-term follow-up was done "naturally" and without randomization, it is very difficult to know if sustained clinical benefit may have been maintained with intensive medication management plus behavioral therapy.…”

Section: Multimodal Treatment Study Of Children With Attention-deficimentioning

confidence: 99%

A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder

Briars

Todd

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Attention-deficit/hyperactivity disorder (ADHD) is a common psychological diagnosis in children. This disorder impacts children and adolescents in all areas of life, including academic performance, extracurricular activities, and social interactions. ADHD can continue into adulthood where unemployment and substance abuse has been described. Although behavioral therapy is recommended for all patients with ADHD, medication management typically is initiated soon after diagnosis. Psychostimulants remain the primary medication of choice. This review focuses on the clinical use of psychostimulant medication in children and adolescents. The pharmacodynamic and pharmacokinetic differences between the newest long-acting formulations as well as commonly encountered adverse drug reactions, with suggested management strategies, will be highlighted. Non-stimulant therapy with atomoxetine or alpha 2 -adrenergic agonists is also reviewed. These agents may be warranted for patients who cannot tolerate psychostimulant therapy or have a comorbid condition. Finally, the 8-year multimodal treatment study results are also discussed.INDEX TERMS: adolescent, alpha 2 -agonist, amphetamine, atomoxetine, attention deficit disorder with hyperactivity, central nervous system stimulants, child, clonidine, methylphenidate, pediatric J Pediatr Pharmacol Ther 2016;21(3) :192-206

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Section: Multimodal Treatment Study Of Children With Attention-deficimentioning

confidence: 99%

A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder

Briars

Todd

2016

The Journal of Pediatric Pharmacology and Therapeutics

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“…Although we recognize differences between the disorders, like central hypersomnia, ADHD is primarily treated with medication but children with ADHD also benefit greatly from psychosocial and educational interventions designed to improve cognitive development, and metacognition. 64 Such behavioral interventions reduce cognitive impairment and improve health, social development, school performance, quality of life, and success in adulthood among children with ADHD. The large randomized MTA study found that both treatment with medication alone and the combined treatment with medication and behavioral interventions result in the greatest improvement in ADHD symptoms.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Characteristics of Children with Central Disorders of Hypersomnolence Versus Matched Healthy Children

Avis

Shen²,

Weaver³

et al. 2015

Journal of Clinical Sleep Medicine

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Background: Hypersomnia of central origin from narcolepsy or idiopathic hypersomnia (IHS) is characterized by pathological levels of excessive daytime sleepiness (EDS). Central hypersomnia has historically been underdiagnosed and poorly understood, especially with respect to its impact on daytime functioning and quality of life in children. Objective: Describe the psychosocial adjustment of children treated for narcolepsy or IHS on school performance, quality of life, and physical/extracurricular activities. Methods: Using a matched case control design, we compared child self-and parent-reported data from thirtythree 8-to 16-year-olds with an established diagnosis of narcolepsy or IHS, according to ICSD-2 criteria, to that of 33 healthy children matched by age, race/ethnicity, gender, and household income. Assessments evaluated academic performance, quality of life and wellness, sleepiness, and participation in extracurricular activities. Results: Compared to healthy controls, children with central hypersomnia had poorer daytime functioning in multiple domains. Children with hypersomnia missed more days of school and had lower grades than healthy controls. Children with hypersomnia had poorer quality of life by both parent and child report. Children with hypersomnia were signifi cantly sleepier, had higher BMI, and were more likely to report a history of recent injury. Finally, children with hypersomnia engaged in fewer after-school activities than healthy controls. Conclusions: A range of signifi cant psychosocial consequences are reported in children with hypersomnia even after a diagnosis has been made and treatments initiated. Health care professionals should be mindful of the psychosocial problems that may present in children with hypersomnia over the course of treatment. Keywords: children, daytime sleepiness, hypersomnolence, daytime functioning Citation: Avis KT, Shen J, Weaver P, Schwebel DC. Psychosocial characteristics of children with central disorders of hypersomnolence versus matched healthy children.

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“…There is evidence that assignment to a medication treatment arm continued to confer some additional benefit after randomization was discontinued for up to 3 years [11]. After 3 years, the effects of the 14-month randomization were no longer evident.…”

Section: Symptom Reductionmentioning

confidence: 99%

Long-Term Effects of Stimulant Treatment for ADHD: What Can We Tell Our Patients?

Craig

Davies²,

Schibuk³

et al. 2015

Curr Dev Disord Rep

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Introduction Stimulant medication is a well-researched treatment for attention deficit hyperactivity disorder (ADHD) and is among the most effective treatments in psychiatry. Parents often want to know more about the long-term risks and benefits of medication. Our objective was to review the seminal papers on long-term outcomes of stimulant treatment for ADHD for the purpose of providing clinicians with the background they need to interpret these findings for patients. Methods We reviewed key articles on long-term outcome of symptoms, comorbidity, substance use, executive functioning, academics, side effects, neurobiology, functioning, and quality of life. Results Stimulants are very effective medications in the short term when used optimally. Long-term randomized, placebocontrolled studies are not feasible. Long-term naturalistic studies are limited by absence of controls.Discussion When administered properly with careful titration, follow-up, and dose adjustment, stimulants are a safe and effective treatment for ADHD with minimal long-term risk and possible long-term benefit.

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A clinical review of outcomes of the Multimodal treatment study of children with attention-deficit/hyperactivity disorder (MTA)

Cited by 11 publications

References 44 publications

A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder

A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder

Psychosocial Characteristics of Children with Central Disorders of Hypersomnolence Versus Matched Healthy Children

Long-Term Effects of Stimulant Treatment for ADHD: What Can We Tell Our Patients?

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