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Long-term effects of stimulant treatment on ADHD symptoms, social–emotional functioning, and cognition

Published online by Cambridge University Press:  13 March 2018

Lizanne Schweren Open the ORCID record for Lizanne Schweren [Opens in a new window] ,
Pieter Hoekstra ,
Marloes van Lieshout ,
Jaap Oosterlaan ,
Nanda Lambregts-Rommelse ,
Jan Buitelaar ,
Barbara Franke  and
Catharina Hartman
Lizanne Schweren*
Affiliation:
Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
Pieter Hoekstra
Affiliation:
Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
Marloes van Lieshout
Affiliation:
VU University Amsterdam, Amsterdam, The Netherlands
Jaap Oosterlaan
Affiliation:
VU University Amsterdam, Amsterdam, The Netherlands
Nanda Lambregts-Rommelse
Affiliation:
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
Jan Buitelaar
Affiliation:
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
Barbara Franke
Affiliation:
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
Catharina Hartman
Affiliation:
Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
*
Author for correspondence: Lizanne Schweren, E-mail: l.j.s.schweren@umcg.nl
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Abstract

Background

Methodological and ethical constraints have hampered studies into long-term lasting outcomes of stimulant treatment in individuals with attention-deficit/hyperactivity disorder (ADHD). Lasting effects may be beneficial (i.e. improved functioning even when treatment is temporarily ceased) or detrimental (i.e. worse functioning while off medication), but both hypotheses currently lack empirical support. Here we investigate whether stimulant treatment history predicts long-term development of ADHD symptoms, social–emotional functioning or cognition, measured after medication wash-out.

Methods

ADHD symptoms, social–emotional functioning and cognitive test performance were measured twice, 6 years apart, in two ADHD groups (stimulant-treated versus not stimulant-treated between baseline and follow-up). Groups were closely matched on baseline clinical and demographic variables (n = 148, 58% male, age = 11.1). A matched healthy control group was included for reference.

Results

All but two outcome measures (emotional problems and prosocial behaviour) improved between baseline and follow-up. Improvement over time in the stimulant-treated group did not differ from improvement in the not stimulant-treated group on any outcome measure.

Conclusions

Stimulant treatment is not associated with the long-term developmental course of ADHD symptoms, social–emotional functioning, motor control, timing or verbal working memory. Adolescence is characterised by clinical improvement regardless of stimulant treatment during that time. These findings are an important source to inform the scientific and public debate.

Keywords

Attentionattention-deficit/hyperactivity disordercognitionmethylphenidatepharmacotherapystimulant treatment
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 2 , January 2019 , pp. 217 - 223
Copyright
Copyright © Cambridge University Press 2018 

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