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.