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Apr 1, 2012

 The Multi Modal Treatment Study of Children With ADHD, also called the MTA study, in results published in the Journal of the American Academy of Child and Adolescent Psychiatry  indicates that children who respond to stimulants such as Ritalin did better in the first year than children who were not taking medication or receiving other treatments.  However, but the end of 14 months most of the children were not taking the medication and in multi year follow ups of those children who were taking the medication they were performing no better than peers who were not taking the medication on measures of academic performance or social interaction.  They were attending better but not necessarily learning better.  Stimlulant drugs were compared to behavioral treatments.  Neurofeedback was not included in the study as a choice for these children.

This suggests that medication for ADHD long term is not any more effective than behavioral strategies.  There are indications however than children at three years somewhat shorter and 6lbs lighter than their peers who did not take the medication.  

There are studies such as ones by Rossiter and Lavaque and more recently by Monastra that indicate that Neurofeedback is equally as effective as Ritalin or stimulants or more so and that Neurofeedback also impacts academic performance.  Tansey has published a study in the Journal of Australian Psychology indicating an increase in IQ  of 7-15 points with Neurofeedback.  That result has been seen by other researchers as well, such as Joel Lubar.  Follow up studies by Lubar, Monastra and others have shown that Neurofeedback patients maintained their gains.  Lubar did the longest follow up of 16 years.  In Monastra's study the control group had to return to medication to function in school and the treatment group of Neurofeedback stayed off their medication and improved their academic performance.  

What should a parent do?  

If medication helps and you need something immediate and the medical risks are acceptable, there is nothing wrong with this as a short term solution.  It is not a life long solution however and its effects will not last.  That is what the evidence seems to indicate.  Neurofeedback on the other hand when properly conducted does last.  If the brain is injured or sustains an illness that may effect the neurofeedback results.  Children, adults and adolescents can be trained while they are medicated; however your physician should work with the neurofeedback therapist to reduce the medication as the treatment becomes more effective.  It is likley that the brain will need less medication or possibly none at all. 

Best Wishes,

Dr. Gluck

See RITALIN GONE WRONG which appeared in the Sunday New York Times Review in articles section or read it HERE

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