Sustained treatment effect in attention-deficit/ hyperactivity disorder: Focus on long-term placebo-controlled randomized maintenance withdrawal and open-label studies

Research output: Contribution to journalArticle

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves "well," and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued longterm ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary.

Original languageEnglish (US)
Pages (from-to)121-130
Number of pages10
JournalTherapeutics and Clinical Risk Management
Volume9
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Drug therapy
ADHD
Attention Deficit Disorder with Hyperactivity
withdrawal
Labels
Placebos
Maintenance
medication
Therapeutics
Appointments and Schedules
physician
Physicians
Drug Therapy
adulthood
adolescence
evidence
abuse
childhood
Clinical Trials
event

Keywords

  • Adult
  • Child
  • Nonstimulant
  • Psychostimulant

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Safety Research
  • Chemical Health and Safety

Cite this

@article{4fbf504472b94a65b9cbff053aa0e89e,
title = "Sustained treatment effect in attention-deficit/ hyperactivity disorder: Focus on long-term placebo-controlled randomized maintenance withdrawal and open-label studies",
abstract = "Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves {"}well,{"} and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued longterm ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary.",
keywords = "Adult, Child, Nonstimulant, Psychostimulant",
author = "David Goodman",
year = "2013",
doi = "10.2147/TCRM.S30762",
language = "English (US)",
volume = "9",
pages = "121--130",
journal = "Therapeutics and Clinical Risk Management",
issn = "1176-6336",
publisher = "Dove Medical Press Ltd.",
number = "1",

}

TY - JOUR

T1 - Sustained treatment effect in attention-deficit/ hyperactivity disorder

T2 - Focus on long-term placebo-controlled randomized maintenance withdrawal and open-label studies

AU - Goodman, David

PY - 2013

Y1 - 2013

N2 - Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves "well," and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued longterm ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary.

AB - Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists throughout life. Approximately two-thirds of patients with a childhood diagnosis of ADHD continue to experience clinically significant symptoms into adulthood. Nevertheless, most of these individuals consider themselves "well," and a vast majority discontinue medication treatment during adolescence. As evidence concerning the adult presentation of ADHD becomes more widely accepted, increasing numbers of physicians and patients will face decisions about the benefits and risks of continuing ADHD treatment. The risks associated with psychostimulant pharmacotherapy, including abuse, dependence, and cardiovascular events, are well understood. Multiple clinical trials demonstrate the efficacy of psychostimulants in controlling ADHD symptoms in the short term. Recent investigations using randomized withdrawal designs now provide evidence of a clinically significant benefit with continued longterm ADHD pharmacotherapy and provide insight into the negative consequences associated with discontinuation. Because many patients lack insight regarding their ADHD symptoms and impairments, they may place a low value on maintaining treatment. Nevertheless, for patients who choose to discontinue treatment, physicians can remain a source of support and schedule follow-up appointments to reassess patient status. Medication discontinuation can be used as an opportunity to help patients recognize their most impairing symptoms, learn and implement behavioral strategies to cope with ADHD symptoms, and understand when additional supportive resources and the resumption of medication management may be necessary.

KW - Adult

KW - Child

KW - Nonstimulant

KW - Psychostimulant

UR - http://www.scopus.com/inward/record.url?scp=84877912558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877912558&partnerID=8YFLogxK

U2 - 10.2147/TCRM.S30762

DO - 10.2147/TCRM.S30762

M3 - Article

C2 - 23576871

AN - SCOPUS:84877912558

VL - 9

SP - 121

EP - 130

JO - Therapeutics and Clinical Risk Management

JF - Therapeutics and Clinical Risk Management

SN - 1176-6336

IS - 1

ER -