Which is better for treating ADHD? Medicate or not?

Both have value in the treatment of ADHD

Medications and non-medication, often lifestyle, approaches have their roles to play in a treatment plan for ADHD. Often, the two approaches support one another, making each more affective. Samuele Cortese, MD, PhD discusses the roles of both.

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ADHD Awareness Month
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I think this is a very important question and not an easy one. There’s been and there is a controversy as to whether we should treat children and adults with ADHD with medication or with non-pharmacologic approaches. And, of course, concerns around a possible side effect of medication [pushing?] the agenda towards, you know, considering more and more non-pharmacological approaches. However, what the evidence – at least some studies say and the synthesis of these studies say – is that if we want to target the so-called core ADHD symptoms – inattention, hyperactivity and impulsivity – medications of the pharmacologic approach should be the preferred option.

However, this does not mean that non-pharmacologic approaches are not helpful. Indeed, there is also evidence showing that non-pharmacological approaches target other areas, other symptoms, and other problems beyond the so-called ADHD core symptoms. So, for instance, behavior parent training, behavioral approaches, are very helpful, and this is supported also by evidence in improving oppositional behavior, conduct disorder, parenting. So I would say to answer your question, I think that it’s fair to say that pharmacological and non-pharmacologic approaches should be both considered for the majority of individuals with ADHD and they target a different but complementary aspect. If we want really to look at the quality of life of the patient, we should consider both.

About the speaker

Samuele Cortese, MD, PhD, is currently professor of Child and Adolescent Psychiatry at the University of Southampton (UK) and Honorary Consultant Child and Adolescent Psychiatry for Solent NHS Trust. Professor Cortese contributes to the editorial management of the systematic reviews/meta-analyses submitted to CAMH. In 2020, he ranked No. 2 worldwide in terms of expertise on Attention-Deficit/Hyperactivity Disorder (ADHD) according to Expertscape.