Stimulants more effective at treating ADHD than placebos, study finds

A study, recently published in the journal Lancet Psychiatry, found that stimulant medications were more effective than placebos at reducing core symptoms of attention deficit hyperactivity disorder (ADHD) in adults during a 12-week period.

Researchers examined 113 published and unpublished randomized controlled trials of nearly 14,900 participants formally diagnosed with ADHD.

Key findings

• Clinicians found that cognitive behavioural therapy, cognitive remediation, mindfulness, psychoeducation, and transcranial direct current stimulation were also more effective than a placebo at reducing ADHD symptoms.
• Certain medications are more likely to be discontinued than placebos due to potentially harmful side effects.
• Patients and clinicians had differing opinions on the effectiveness of non-pharmacological treatments versus a placebo.

“[Non-pharmacological treatments] are designed to teach coping skills to reduce the impact of symptoms on one’s life,” Dr. Edoardo G. Ostinelli, the study’s author, said during the Science Media Centre briefing.

“So, if the primary outcome in this review had been impairment or ADHD coping skills, or psychological variables like self-worth or self-efficacy or sense of autonomy—you might have seen different findings.”

Ostinelli added it’s likely, based on the findings, that there isn’t a one-size-fits-all solution for ADHD.

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Reaction from experts

Dr. Philip Shaw, professor in the Institute of Psychiatry, Psychology & Neuroscience at King’s College London:

“The study shows that there are effective interventions for adults living with ADHD who are looking for ways to reduce any unwanted impact from symptoms,” Shaw said in a statement to the Science Media Centre.

“The downside was that some medications had troublesome side effects, though this wasn’t the case for psychostimulants, which are the most widely used medication.”

Dr. Margaret Sibley, professor of psychiatry and behavioural sciences at the University of Washington School of Medicine:

“The review [highlights] a continual challenge when conducting ADHD research with adults,” Sibley told CNN.

“Self-perception of ADHD symptoms is fallible in all people. They are somewhat subjective symptoms. However, there are no ‘objective’ tests that can accurately measure ADHD symptoms. Best practice is actually to use informant reports (i.e., reports of loved ones) in combination with self-report when assessing adult ADHD.”

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