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Nondrug ADHD treatments not very effective

May 18, 2013

I was recently invited to write an editorial for an international medical journal on a study by Sonuga-Barke and colleagues. This published study was an extensive review and analysis of published research looking at several different nondrug treatments for ADHD. My editorial will be published by the British Medical Journal in Evidence-based Mental Health June 2013. Dr. Sonuga-Barke’s analysis looked at 2904 studies of which 59 were selected because they satisfied high-quality data. I’m unable to provide my editorial text as the manuscript is embargoed until publication.

Dr. Peter Yellowless briefly reviews the study conclusion in a Medscape video.

The study divided treatments into several categories: restrictive elimination diet, artificial food color exclusion, free fatty acid supplementation, cognitive training, neurofeedback and behavior interventions. Only artificial food color exclusion and free fatty acid supplementation were statistically significantly effective, although the effect was relatively small.

Single clinical trials are often published showing some positive benefit. These studies then receive media coverage, especially if published in high impact journals. However, publication bias exists because negative studies often don’t get published, leaving readers with a false sense of benefit.

Publications like Dr. Sonuga-Barke’s help doctors and patients review multiple studies to see if replication of positive findings occurs. Evidence-based medicine in not based on single study reports but on the accumulation of studies over time.

As I like to say “On the highway of opinions, let science be the designated driver.” David W. Goodman, M.D.

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