Setting the Record Straight on ADHD Medications

Yesterday we posted a point-by-point response to the New York Times op ed piece that ran Sunday, “Ritalin Gone Wrong,” by Dr. L Alan Sroufe. In our rebuttal Dr. Harold Koplewicz explains the stunning misreading of the research on which Dr. Sroufe bases his claim that ADHD medications don’t work. Since we’re getting a lot of distressed calls and emails, and in case you don’t have time to read the long version, I wanted to give you the most important facts here.

Dr. Sroufe cites a 2009 study of children followed over 8 years that he says showed that medication doesn’t work after the first two years. What he doesn’t say is that they stopped treating the children in the study after the first two years! No one claims that stimulant medications cure ADHD; rather we know from incontrovertible research and clinical experience that it helps many, many children while they are taking it.

Dr. Sroufe also makes the mistake of conflating all children who have “behavior problems” with children who have been diagnosed with ADHD. Of course there are some kids whose symptoms look like ADHD—they’re distracted, impulsive, have trouble self-regulating—but stem from something else, including stressors in their environment. The fact that ADHD medications don’t work on all “problem children” doesn’t undermine the fact that they work really well for many kids who really do have ADHD.

It’s certainly true that parental patterns influence children’s behavior, and that changing those patterns can help a child learn to rein in his own impulsivity. That’s why parent-child interaction therapy (PCIT) can make a big difference. But PCIT doesn’t cure the core symptoms of ADHD; in fact kids with severe ADHD usually have to be on medication to be able to focus enough on the training sessions to learn effectively from them. We agree with Dr. Stroufe that knee-jerk medication isn’t the answer for all kids with problematic behavior, but denying that it helps many kids isn’t a good way to make that case.