Three studies published in the August issue of the Journal of the American Academy of Child and Adolescent Psychiatry report that combining two standard medications could lead to better clinical results for children with attention-deficit/hyperactivity disorder than either ADHD therapy alone.
At present, studies report that the use of several medications for ADHD result in significant reductions in symptoms. However, so far there is no undoubtable evidence that these medications also improve long-term social, academic, and clinical outcomes. Research suggests that both the degree of cognitive dysfunction and the severity of ADHD symptoms that remain despite treatment contribute to poorer outcomes. Thus, more effective therapies need to be identified.
A group of researchers led by Drs. James McCracken, Sandra Loo, and Robert Bilder of the UCLA Semel Institute performed three interlocking studies examining the effects of combined pharmacotherapy by standard medications on clinical, cognitive, and brain activity measures by recruiting a sample of children and adolescents 7-14 years of age with and without ADHD. Combined therapy was hypothesized to be superior to the two standard medications, d-methylphenidate and guanfacine, on both clinical and cognitive outcomes, and was expected to show a distinct profile of effects on brain wave activity (EEG). Participants with ADHD were randomly assigned to eight weeks of double-blinded treatment with either d-methylphenidate, guanfacine, or a combination of the two.
The results showed consistent added benefits for the combined treatment over the two single treatments, especially for symptoms of inattention, and more global response indices. The rate of good clinical response went up from 62-63% in the single drug therapy to 75% in the combined therapy.
Based on these findings, the authors conclude that combining stimulants with medications like guanfacine warrants more consideration even in children with ADHD who benefit from monotherapies.
- Psychoscience.am (28 April, 2016). The death of newborn neurons may be linked to 5 mental disorders.
- Psychoscience.am (5 March, 2016). ADHD and growing academic demands.
- Begoyan A., Sargsyan T., Harutyunyan N. (2015). Treating ADHD: Strategies to improve memory.
- Sandra K. Loo, Robert M. Bilder, Alexander L. Cho, Alexandra Sturm, Jennifer Cowen, Patricia Walshaw, Jennifer Levitt, Melissa Del’Homme, John Piacentini, James J. McGough, James T. McCracken. Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 2016; 55 (8): 674 .
- James T. McCracken, James J. McGough, Sandra K. Loo, Jennifer Levitt, Melissa Del’Homme, Jennifer Cowen, Alexandra Sturm, Fiona Whelan, Gerhard Hellemann, Catherine Sugar, Robert M. Bilder. Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study. Journal of the American Academy of Child & Adolescent Psychiatry, 2016; 55 (8): 657.
- Robert M. Bilder, Sandra K. Loo, James J. McGough, Fiona Whelan, Gerhard Hellemann, Catherine Sugar, Melissa Del’Homme, Alexandra Sturm, Jennifer Cowen, Grant Hanada, James T. McCracken. Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 2016; 55 (8): 667.