Stimulant treatment over five years: adherence, effectiveness, and adverse effects
Abstract
Objective To evaluate the impact of adherence and medication status on effectiveness and adverse effects of stimulant use in children with attention-deficit/hyperactivity disorder (ADHD) over 5 years.Method Seventy-nine of 91 participants in a 12-month randomized controlled trial of methylphenidate and parent groups enrolled in a follow-up study. Adherence to stimulants, treatment response, and adverse effects were evaluated annually for 5 years. Changes in teacher-reported symptoms and parent-reported adverse effects were compared at 2, 3, 4, and 5 years for 3 groups: adherents, nonadherents on medication, or nonadherents off medication. Controlling for age, gender, and baseline severity, adherence status and medication status were evaluated as correlates of teacher-reported ADHD symptom scores at each year using multiple regression analyses.Results At 2 years, adherents (n = 41) showed greater improvement in teacher-reported symptoms than those off medication (n = 16) and equivalent response to nonadherents on stimulants (n = 16) (p =.02). At 5 years, adherents (n = 16) showed greater improvement in teacher-reported symptoms than nonadherents on stimulants (n = 15) and those off medication (n = 14) (p =.04). At year 2 medication status (beta = 4.67 [0.40-8.95, p =.033]) and at year 5 adherence status (beta = 7.23 [3.01-11.44, p =.001]) correlated with higher teacher-reported symptom scores. Clinically significant adverse effects were present for 5 years, most commonly loss of appetite.Conclusions Psychostimulants improve ADHD symptoms for up to 5 years, but adverse effects persist.
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In children with ADHD, long-term stimulant treatment was associated with greater improvement in teacher-reported symptoms than discontinuation.
“children with attentiondeficit/hyperactivity disorder (ADHD) who participated in long-term stimulant treatment exhibited greater improvement in teacher-reported symptoms than those who discontinued stimulant medications.14”
From Medication Adherence in the MTA: Saliva Methylphenidate Samples Versus Parent Report and Mediating Effect of Concomitant Behavioral Treatment (2009) · cites this paper as [14]
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- Authors
- Charach, A., Ickowicz, A., & Schachar, R.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Charach, Alice
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2004-05
- Volume
- 43
- Issue
- 5
- Pages
- 559-567
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2066150304
- Cited by
- 315
- References
- 32
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 14 · 2021: 11 · 2020: 5 · 2019: 9 · 2018: 9 · 2017: 14 · 2016: 16 · 2015: 22 · 2014: 20 · 2013: 20 · 2012: 19
- FWCI
- 10.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, methylphenidate, long-term treatment outcomes, treatment effectiveness, adverse effects, appetite loss, children
- MeSH terms
- Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Demography, Follow-Up Studies, Humans, Methylphenidate, Patient Compliance, Surveys and Questionnaires, Diagnostic and Statistical Manual of Mental Disorders
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