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Long-Term Stimulant Medication Treatment of Attention-Deficit/Hyperactivity Disorder: Results from a Population-Based Study

BARBARESI, WILLIAM J. M.D.1; KATUSIC, SLAVICA K. M.D.2; COLLIGAN, ROBERT C. Ph.D.3; WEAVER, AMY L. M.S.4; LEIBSON, CYNTHIA L. Ph.D.2; JACOBSEN, STEVEN J. M.D., Ph.D.2

Journal of Developmental & Behavioral Pediatrics: February 2006 - Volume 27 - Issue 1 - p 1-10
Original Articles

ABSTRACT. The purpose of this study was to offer detailed information about stimulant medication treatment provided throughout childhood to 379 children with research-identified attention-deficit hyperactivity disorder (ADHD) in the 1976-1982 Rochester, MN, birth cohort. Subjects were retrospectively followed from birth until a mean of 17.2 years of age. The complete medical record of each subject was reviewed. The history and results of each episode of stimulant treatment were compared by gender, DSM-IV subtype of ADHD, and type of stimulant medication. Overall, 77.8% of subjects were treated with stimulants. Boys were 1.8 times more likely than girls to be treated. The median age at initiation (9.8 years), median duration of treatment (33.8 months), and likelihood of developing at least one side effect (22.3%) were not significantly different by gender. Overall, 73.1% of episodes of stimulant treatment were associated with a favorable response. The likelihood of a favorable response was comparable for boys and girls. Treatment was initiated earlier for children with either ADHD combined type or ADHD hyperactive-impulsive type than for children with ADHD predominantly inattentive type and duration of treatment was longer for ADHD combined type. There was no association between DSM-IV subtype and likelihood of a favorable response or of side effects. Dextroamphetamine and methylphenidate were equally likely to be associated with a favorable response, but dextroamphetamine was more likely to be associated with side effects. These results demonstrate that the effectiveness of stimulant medication treatment of ADHD provided throughout childhood is comparable to the efficacy of stimulant treatment demonstrated in clinical trials.

1Department of Pediatric and Adolescent Medicine, Division of Developmental and Behavioral Pediatrics, Mayo Clinic College of Medicine

2Department of Health Sciences Research, Division of Clinical Epidemiology, Mayo Clinic College of Medicine

3Department of Psychiatry and Psychology, Mayo Clinic College of Medicine

4Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic College of Medicine

Received April 2005; accepted August 2005.

Address for reprints: William J. Barbaresi, M.D., Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905; e-mail: barbaresi.william@mayo.edu.

© 2006 Lippincott Williams & Wilkins, Inc.