Study re long term effectiveness of stimulant medication

http://www.medscape.com/viewarticle/480582_3

Stimulant Treatment Over Five Years: Adherence, Effectiveness, and Adverse Effects
Charach A, Ickowicz A, Schachar R
Journal of the American Academy of Child and Adolescent Psychiatry. 2004;43(5):559-567

The study authors noted that despite the widespread use of stimulants in children with attention-deficit/hyperactivity disorder (ADHD), few studies have examined efficacy and safety for long-term use. Studies have documented short-term therapeutic benefits but no systematic reports for continuation of benefits exist, and clearly many children treated with stimulants of ADHD still develop poor clinical outcomes in adolescence and adulthood. The current study examined the 5-year follow-up of 91 children with ADHD who had originally participated in a 1993-1995 randomized clinical trial of methylphenidate treatment to investigate adherence to treatment as well as the presence/absence of adverse effects. The authors were able to complete 5 annual follow-ups on 69 of the 91 participants and analyzed data by 3 groups: adherents, nonadherents on medication, or nonadherents off medication. Parent and teacher reports of treatment response as well as parental reports of adverse effects were noted at each reassessment. The results indicated that at 2 years (N = 41) and 5 years (N = 16), adherents to stimulants showed greater improvements in teacher-reported symptoms. The most common adverse effect was loss of appetite, an effect persisting throughout the years of study. Despite several limitations, the study indicated that therapeutic benefit is sustained by long-term use of stimulants, especially in those children presenting with clinical severity at baseline, but adverse effects persist.