Early Treatment of ADHD Improves Outcomes

Timothy Wilens, MD, Chief, Division of Child and Adolescent Psychiatry, and Co-Director, Center for Addiction Medicine, Massachusetts General Hospital, Boston, Massachusetts, discusses the ways in which early treatment can improve outcomes in patients with attention-deficit/hyperactivity disorder (ADHD). 

Dr Wilens spoke at Psych Congress 2020 on "Stimulants in ADHD: Friend or Foe?"

Read the transcript:

Dr Wilens: A common question is, what does treatment do for ADHD short-term, but more importantly, long-term? Certainly, in context to the lecture and in terms of understanding the treatment of ADHD, over time is to really explore that. First of all, the easy answer is it reverses many of the problems that ADHD brings with it, either difficulties that ADHD causes or sequela of ADHD.

For example, we know that from an academic standpoint if you look at the totality of information out there that there's improvements in academics, better GPAs, better test-taking, better overall scores, better achievement of potential, over both high school and college.

In addition, you see improvements in things such as psychiatric issues. Whereas ADHD increases the risk for, let's say, mood disorders, there's a reduction in the ultimate development of mood disorders in treated groups. Really importantly, people worry about, for example, stimulant effects which are controlled substance use. It turns out untreated, increased risk.

With treatment, you see reductions not only in cigarette smoking but also in drug and alcohol use disorder. There's a pretty substantial reduction.

Other considerations are that when you're driving a motor vehicle, both short-term and long-term treatment reduces the likelihood to develop a motor vehicle accident. We've demonstrated that in driving simulation studies. Also, if you look at large registry studies of individuals who are treated, or untreated, or even people during times that they're not treated are at a substantially increased risk for motor vehicle accident. It's treatment that reduces that risk.

Similar findings are for accidents, reductions in accidents, and reductions in concussions and traumatic brain injury associated with treatment. Overall, we find a compelling story that treatment reduces or mitigates many of the increased risks that are associated with the untreated state for ADHD.

Timothy Wilens, MD, is the chief of the Division of Child and Adolescent Psychiatry; co-director of the Center for Addiction Medicine; and director of the Substance Abuse Services in Pediatric Psychopharmacology at Massachusetts General Hospital for Children in Boston, Massachusetts, in addition to serving as an associate professor of psychiatry at Harvard Medical School in Boston, Massachusetts. His clinical interests include pediatric psychopharmacology, ADHD, and substance use disorders. He received his MD from the University of Michigan Medical School and completed a residency at Massachusetts General Hospital in child, adolescent, and adult psychiatry.