Why do ‘ADHD medications’ appear to work?

There is no doubt biochemical interventions are the most immediate method of altering behaviour. However, using ‘medication’ masks symptoms, does nothing to address the causes of real problems, risks a host of adverse side effects and creates withdrawal effects that worsen ‘baseline behaviours’.

The most commonly used drugs to treat ADHD are the amphetamine-based psycho-stimulants dexamphetamine (current brand names Adderall, Dexedrine, Dexostrat) and the near amphetamine methylphenidate (Ritalin, Concerta, Attenta).[1] The effects of medicinal amphetamines are virtually indistinguishable from illicit ones. In the USA methamphetamine (brand name Desoxyn) is used as an ADHD treatment.

When taken orally in low doses all these drugs will temporarily sharpen focus in most people regardless of their ADHD status. As a result parents and teachers often see increased concentration and more compliant behaviour as immediate effects.

However, the stimulant effects are very short, lasting a matter of hours with ‘no evidence that the medications promote or cause psychological, social, or emotional growth’ in the long term.[3] When the short-term stimulant effects of the drugs wear off there are often “bounce” or withdrawal effects that worsen ADHD type behaviours.[2] Ironically, witnessing the rebound effect reinforces parents’ and teachers’ belief that the child is chemically imbalanced without the drug and that he or she needs to keep taking medication.

Most of the evidence supporting the use of ADHD drugs comes from drug company sponsored research trials which usually last for a few weeks or months. In short-term research trials, pharmacological interventions invariably appear more effective than non-drug treatments for two reasons. First, drugs alter behaviour much faster than non-drug treatments, and trials most often measure improvements by short-term symptom management. Second, while the behaviour-altering effects of stimulants are almost universal, other forms of treatment are not. Family counselling, for example, will be of little or no benefit if the underlying cause of behavioural problems is exposure to environmental toxins.

For more information on the evidence used to justify the use of ADHD drugs see Pseudoscience supporting ADHD

[1] Other less commonly used brand names for methylphenidate include Methylin, Daytrana, Rubifen, Equasym and Metadate.

[2] Peter R. Breggin, M.D., Talking Back to Ritalin: What Doctors Aren’t Telling You about Stimulants for Children, Common Courage Press, Monroe, 1998, p.22.

[3] Lydia Furman, ‘What is Attention-Deficit Hyperactivity Disorder (ADHD)?’, Journal of Child Neurology, Vol. 20 No. 12, 2005, p 998. Victoria BC, Trafford Publishing (2006): p6.