Stimulant medications for the treatment of ADHD: Efficacy and limitations

A large literature exists on the use of stimulant medications to treat children with attention deficit hyperactivity disorder (ADHD). In 1993, we summarized this literature in a "review of reviews" for the U.S.Department of Education, as part of the Individuals with Disabilities Education Act (IDEA)-inspired changes in regulations about the identification and treatment of ADHD students in public schools. Ten critical issues were identified by panels of experts, and based on the literature consensus, views were identified for each topic, which provided an evaluation of strengths and weaknesses of stimulant pharmacotherapy. In this article, we provide an update of the "review of reviews" by identifying new investigations relevant to critical areas that might change the consensus views. We also summarize the recent presentations of the initial results of the MTA Study (Multimodality Treatment study of children with ADHD), which addresses many of the critical issues. We draw conclusions about the current views on strengths and weaknesses of stimulant pharmacotherapy based on this historical approach and selective review of recent research. (C) 1999 Wiley-Liss. Inc.