Pubdate: Wed, 15 Dec 1999 Source: Orange County Register (CA) Copyright: 1999 The Orange County Register Contact: P.O. Box 11626, Santa Ana, CA 92711 Fax: (714) 565-3657 Website: http://www.ocregister.com/ Author: HOLCOMB B. NOBLE-The New York Times STUDY FINDS THAT RITALIN HELPS HYPERACTIVE KIDS MEDICINE: Researchers say the drug is more effective than behavioral therapy. In one of the largest studies of its kind ever conducted, researcher's have found that the drug Ritalin, the object of sharp debate for three decades, was more effective than behavior-modification therapy in treating children with attention deficit hyperactivity disorder. The researchers, who worked at six sites around the country in teams assembled by the National Institutes of Health, said that adding the behavioral therapy to Ritalin treatment was no more effective than the drug alone. But they said they found that about 70 percent of the children they studied also turned out to have problems like depression and anxiety. In those cases, they said, behavior therapy provided significant benefits, especially when used in combination with the Ritalin. The results, reported in the current issue of the Archives of General Psychiatry, were discussed at a news conference Tuesday at Columbia University. Dr. Peter S.Jensen, a child psychiatrist at Columbia and a senior adviser to the NIH who directed the project, said the results were "the first real information on comparative treatments over the long term." Dr. James T. McCracken, the director of child and adolescent psychiatry at the Neuropsychiatric Institute of the University of California at Los Angeles, who was not involved in the research, called the study a landmark and said it proved the benefits of treating hyperactive children with a stimulant. "As a child psychiatrist, it is still surprising that Ritalin remains as controversial as it is," he said. "One hopes that this study will put some of the controversy to rest." Dr. William Carey, a child psychiatrist at the Children's Hospital of the University of Pennsylvania, said that while he had no criticism of the study, Ritalin is overused, adding, "Do you give it to a child who talks incessantly in line?" The drug should be reserved for real brain disorders, he said. One of the most recent battles over the drug took place last month when the Colorado Board of Education moved to discourage teachers from recommending behavioral drugs like Ritalin and urged school personnel to use discipline and instruction instead to overcome problem behavior in the classroom. The action was said the have stemmed from fears that such drugs were related to violence among children, although medical scientists say there is no evidence of that. Its side effects, which include headaches or loss of appetite, are reported as minor and reversible. The NIH researchers studied 579 children over 14 months. The children, who were 7 to 9 years of age, were given long and detailed examinations, Jensen said. About 80 percent were boys. Treatments of the children were divided into four groups; those that received Ritalin alone, received intensive behavior management therapy alone, a combination of the two, and whatever kind of treatment was standard for their community. The researchers found that among the children who had attention deficit hyperactivity disorder but not the other psychiatric disorders, Ritalin brought improvement in their conditions when it was used alone, regardless of whether it was accompanied by other therapy. They also found that Ritalin and the intensive behavior therapy used in combination were the most effective when used for the children with psychiatric problems that went beyond attention deficit hyperactivity disorder. Dr. Stephen P. Hinshaw, a child psychiatrist and professor at the University of California, Berkeley, said they included monthly meeting under the NIH approach and more emphasis on behavior management by parents and teachers. - --- MAP posted-by: Don Beck