What the multimodal treatment study of children with attention deficit/hyperactivity disorder did and did not say about the use of methylphenidate for attention deficits.

Abstract

* Abbreviations: ADHD = : attention-deficit/hyperactivity disorder • MTA = : Multimodal Treatment Study of Children with ADHD The December 1999 issue of the Archives of General Psychiatry contained 2 articles1 ,2 and a commentary3 about the Multimodal Treatment Study of Children with attention-deficit/hyperactivity disorder (ADHD; MTA). At the time of publication the findings were reported widely in the general press with varying degrees of accuracy. A common misperception has been created that it concluded that methylphenidate (Ritalin) is the sole answer for children's problems with inattentiveness and activity and that behavioral management is not particularly beneficial. This commentary reviews what the report actually did and did not say. Misunderstandings by practitioners, teachers, and insurance companies could have unfortunate consequences. 1. In describing this 14-month investigation of 579 elementary school children 7 to 9 years of age, the National Institute of Mental Health press release announced: “The MTA study has demonstrated, on average, that carefully monitored medication management with monthly follow-up, with input from teachers, is more effective than intensive behavioral treatment for ADHD. The combination of medication management and intensive behavioral treatments was also significantly superior to psychosocial … Address correspondence to William B. Carey, MD, 511 Walnut Lane, Swarthmore, PA 19081-1140. E-mail: wbcarey{at}worldnet.att.net