The problem with current treatments for attention-deficit hyperactivity disorder (ADHD) is that medications typically play an important role in controlling symptoms, but symptoms resurface when the medication wears off1. Unfortunately, there are few if any enduring benefits from medications used to treat ADHD. This is seen most clearly in the follow-up analyses of the NIH-sponsored Multimodal Treatment Study of Children with ADHD (MTA)2. Initially, they found that careful medication management, or medication management combined with behavioral treatment of children with ADHD, produced better outcomes at 14-months than did behavioral treatments alone or community care. However, when participants were reassessed 2 years after the studies end2, or 6-8 years post enrollment3, it was clear that there were no significant beneficial effects on ADHD symptoms or academic performance, of having received 14-months of medication management or medication management combined with behavioral treatments2, 3. Consequently, we are interested in non-pharmacological treatments that may have enduring beneficial effects on children with ADHD.
Treatments with enduring beneficial effects may require many weeks or months to work. Hence, an ideal long-term treatment might function in conjunction with pharmacological treatments so that ADHD children can receive some rapid short-term beneficial effects of medication, but they then may be able to stop using medications, or benefit from lower doses of medications, as the long-term treatment takes hold.
We are currently studying three potential non-pharmacological treatments for ADHD in the Developmental Biopsychiatry Research Program at McLean Hospital, a major Harvard Teaching Hospital.
Research Project 1. In this study, we are comparing two non-pharmacological treatments in boys and girls with ADHD who are 8 – 12 years of age. This is a 6-month long free treatment program that we provide in addition to whatever treatments the child is currently receiving. Hence, they can be taking medication, receiving counseling, family therapy, school accommodations, etc. An important requirement though is that if they are taking medications that the medications be short acting (like Ritalin, Adderall or Atomoxetine) that can be stopped for 2 days so we can assess how symptomatic the child is off medication at the beginning, middle and end of the study. Non-invasive MRI scans will also be performed at the beginning and end of the study to determine if the non-pharmacological treatment led to any alterations in blood flow and connectivity in brain regions implicated in ADHD. Children will receive a comprehensive evaluation as part of the study. They can also enter the trial if they are not receiving any other treatments. All components of this study are free. Monies are provided to help cover local traveling expenses to McLean Hospital and to compensate children for their time going through the different evaluations. Participants are randomly assigned to either Treatment 1 or 2. If two children from the same family enroll they are randomly assigned to the same treatment. This is an ongoing study but still has several openings for new participants as of 11/20/15.