
ADHD Drugs Don't Boost Kids' Grades, Studies Find - gruseom
http://wsj.com/article/SB10001424127887323368704578593660384362292.html
======
X-Istence
Each time a study comes out and people will link it to me (I've already had
this linked to me three times) claiming that my ADHD medicine doesn't do
anything and that it is worthless ... for me it isn't. Without my meds I
wouldn't be able to concentrate, I wouldn't be able to get work done. At one
point it got so bad at work that I was afraid I was going to get fired since I
couldn't focus on any single task at hand at all.

Starting on Aderall has changed my life. I am able to concentrate on work, I
get more done, I feel calmer, it is almost as if a fog has been lifted and I
can clearly see what I am working on. It has been a complete shift, like the
difference between day and night.

When I don't take my meds (doctor recommended breaks) I go back to being the
old me, I become disorganised, I am constantly distracted and thinking about
other things. I lose focus and space out. I don't like that person, because I
feel like I don't accomplish anything :-(.

~~~
linohh
What many people don't understand is the stress people with ADD are exposed
to. Especially when they're smart.

Imagine having a porsche in your driveway, but for reasons you can only use
the first gear. No matter how hard you push the pedal to the metal, you won't
be as fast as you want the car to go. Plus if you keep going full throttle in
the first gear eventually you'll break something.

Sounds depressing, doesn't it? And that's exactly what happens. People
eventually get depressed. It won't go away by itself. When they go to the
doctor, it's basically a game of chance. If the doctor is competent, he'll do
the proper tests. Unfortunately most aren't. There are a lot of syndromes,
illnesses, conditions that match the symptoms.

If the ADD patient is lucky, the correct diagnosis is made. If unlucky, he may
be treated for borderline, depressions, etc. Antidepressants may worsen the
condition, because they may increase motivation without increasing ability.

A well diagnosed and medicated ADD patient however will lose depression in
almost no time.

~~~
reneherse
Wow, this sounds exactly like what I've been experiencing for the last four to
five years. Even the misdiagnosis, which have mostly turned me off from
seeking any kind of mental health treatment. Can you recommend how to screen
for a competent psychiatrist specializing in adult ADD?

~~~
stevewillows
I live in Vancouver and have had the best success working directly through the
local hospital's mental health group. The key is to do a lot of testing. I've
also found pink noise to help quite a bit in those times where I need an extra
bit of focus.

A misdiagnosis and even the wrong medication is the worst to experience.
Finally in my 33rd year of life (18 years since finding out about ADHD) I
found a medication that helps my anxiety and depression which allows me to
focus on the downsides of the ADHD.

This isn't an ad for mirtazipine. :)

~~~
doktrin
> _This isn 't an ad for mirtazipine. :)_

Genuinely curious - do you in fact take mirtazipine to manage AD(H)D? I've
never had it recommended as a treatment option.

~~~
stevewillows
It's mainly for the depression - - but I've found since starting the
medication that I've been able to focus far better than before. There are some
studies around where they tested this drug for ADHD with kids.

I've tried a few other drugs for both ADHD and depression / anxiety over the
years, but this one seems to be the sweet spot between helping with
everything. Hardly scientific, but it's my experience.

I should note that at lower doses mirtazapine (remeron) helps with insomnia.
For me, I'm on a higher dose (45mg) where this isn't the case.

~~~
stevewillows
To add to this; If any of you with ADHD have found that you're miraculously
killing at Scrabble or Boggle after a few drinks, being on this medication is
a similar feeling. It's as if the anxiety or whatever is the noise and the
medication filters that out.

------
benjamincburns
So we're going to look at grades as an indicator of success here? Grades,
which have been shown time and time again to have very weak, if any
correlation with success?

I've dealt with ADHD my entire life. As a kid people could see I was smart,
but "if only he could apply himself!" One of the most pivotal decisions I ever
made was to seek counseling, and ultimately medication, when I was flunking
out of college. My grades improved enough to get me through undergrad. However
they were never stellar because I was finally able to focus on all of the
various ideas I had kicking around in my head that I was far, far more
passionate about.

I could rattle off a list of crazy successes that I would have never been able
to achieve had I never sought medication, but honestly it boils down to one
thing. When I want to do something that requires mental focus, said mental
focus is no longer a barrier. I can actually do it. Because of that, I'm
happy.

So instead of grades, what about quality of life?

~~~
jt2190

      > So we're going to look at grades as an indicator of 
      > success here? 
    

Yes, because children who suffer from poor grades are now frequently tested
for ADHD, and since we can't very accurately diagnose ADHD, some children who
don't need the medication will get it. It's called a "false positive." Those
children's grades won't improve. The studies are really telling us that we're
not very good at diagnosing this.

~~~
benjamincburns
That's a very valid statement, and I greatly appreciate/respect that truth. If
that were the tack this article were taking, I'd have no qualms. This is the
perfect kind of study to combat overprescription based on poor academic
performance.

However there's an unwritten assumption in this article that grades are
synonymous with success. See the caption to Dr. Farah's photo. That's a very
poor inference. That's what I'm taking offense to.

~~~
jt2190
I read it as "success in treatment", not "success in life."

~~~
benjamincburns
Me too.

------
gordaco
The ADHD craze is rampant on the USA, but fortunately not in Europe, where I'm
from. I'm so glad of that, even if I'm more or less on the opposite side of
ADHD when it comes to focus and behaviour.

Don't get me wrong, I'm not denying that ADHD is a thing. However, it seems
that in the USA it's heavily overdiagnosed, and even worse, the educational
system seems to be especially harmful to people with actual ADHD (some people
argue that it's because of that system being focused on certain skills, but I
honestly don't think it's so different here). It seems like some kind of ADHD-
phobia that pushes schools to find a huge problem whenever any faint symptom
is found, immediately resorting to medication and severely punishing those who
don't comply.

~~~
conradfr
Well great. But being in France I would have loved to have a chance to even
know ADD existed before I found it myself online at the age of 29.

And I think there is maybe only 3 doctors in Paris that diagnose it. And the
only medication available is Ritaline / Concerta.

------
thejosh
Yes it won't boost their grades, but it will actually make them be able to be
"normal" people.

People haven't lived with someone with actual/bad ADHD if they think drugs
don't work.

~~~
pvnick
As somebody who grew up with "actual/bad ADHD," I find this statement,
frankly, insulting. As a result of being drugged with Ritalin/Adderall
throughout my childhood, I've had this notion of being somehow "wrong" or
"broken" ingrained in my psyche, an effect with which I still struggle to this
day. There are plenty of schools in which to enroll children with ADHD, and
there are a ton of career paths - generally related to creative thinking - in
which we can express ourselves freely without the stigma of being somehow
"abnormal."

Have you ever actually taken an adderall? It has an intense narcotic effect,
which is why people abuse it. I can't believe we give it to our children.

~~~
DannyBee
Adderral does not have an intense narcotic effect for me.

You can also nowadays take straterra, which is a non-stimulant.

Honestly, if your ADHD is so low level that you can function well without
drugs, more power to you. There are plenty of ADHD people who literally
cannot, and to imply they could just take career paths involving "creative
thinking" is, IMHO, somewhat wishful thinking.

~~~
pvnick
While I'm happy to hear that some have found a way to control their
"affliction," I've never tried Straterra and have no plans to start. As I
alluded to in my original post, my ideological objections to drugging our
"broken" children are more than simply pragmatic. And, even though I'm a mid-
twenties male in college, I hardly ever go to class as I still can't manage to
sit still long enough to listen to a 50 minute lecture. I read the textbooks
instead and ace the tests.

Anecdotally (I use that word conservatively as I've read studies to this
effect but don't care to look them up), I've found that those with ADHD,
including myself, are more creative than "normal" people. Something about the
non sequitur way in which our minds work. So it's a difference in strengths,
not a difference in mental quality.

I also noticed I'm using a lot of quotes in my reply. I guess my cynicism is
expressing itself through my sarcastic tone.

~~~
DannyBee
"As I alluded to in my original post, my ideological objections to drugging
our "broken" children are more than simply pragmatic. "

Do you have similar objections to drugging alzheimers patients?

I'm trying to understand where you draw the line.

Given that actually diagnosed ADHD people have brain chemistry differences
that various drugs are meant to control, i have trouble seeing a difference
between the two cases.

If you want to pretend you aren't neurologically different than others, great.
Maybe you aren't! Plenty are.

If you believe ADHD is a biological advantage that shouldn't be chemistry'd
out, again great. Convince enough people, and eventually evolution will win.

~~~
pvnick
I don't remember ever being afflicted with Alzheimer's, so I can't speak to
that case.

But what is evident is that ADHD affliction is a broad, very continuous
spectrum and not a black/white "disease" in the traditional sense. It's
largely based on subjective factors. The hypochondriac parent will very easily
convince a doctor to prescribe ADHD medication for his/her child. This
reality, in addition to my own personal experience, leads me to believe that
"ADHD" is less a disorder and more just a feature, like having brown eyes or
fair skin.

~~~
DannyBee
I guess I strongly disagree.

Just because diagnostic conditions are not always clear, or overdiagnose, does
not make it any less of a disease.

A lot of things mental disorders are based on subjective factors.

Would you disagree that schizophrenia is a disease?

At least 3 of the factors (and you only need two) are _highly_ subjective.

If you wanted to argue that DSM-IV/DSM-V criteria for a lot of things have a
tendency to overdiagnose or not be objective enough, I would heartily agree.

That does not make something any less of a disease, it only means our
diagnostic criteria suck.

Alzheimers had very broad, subjective, diagnostic criteria once as well, right
up until they made various breakthroughs in neuropathology.

Yet you seem willing to class that as a disease?

------
lsiebert
Focus and memory isn't enough, is the takeaway from this article.

You have to teach people good study habits, habits they won't necessarily have
if they have ADHD/ADD. That focus is great, but only if properly targeted
towards the tasks that need to be accomplished and the material that needs to
be learned.

~~~
Wingman4l7
Not to mention that all the drugs in the world can't make a kid care about
completing the scutwork some schools dish out.

~~~
bayesianhorse
Sitting still at least some of the time and not attacking fellow students and
teachers more than they deserve is certainly a good start...

------
lolwutf
As someone who grew up with ADHD managed by stimulant drug therapy since age
7, I can earnestly say that my experience was that ADHD drugs did boost my
grades and were a crucial factor in my career success, to date (and still
are).

~~~
DannyBee
I completely agree. I was diagnosed and have been treated since around age 7.
This was before ADHD was 'popular', and at a point in time when they thought
it just went away when you got older.

At least, as written, the article talks about something different from the
study. The article says "However, a growing body of research finds that in the
long run, achievement scores, grade-point averages or the likelihood of
repeating a grade generally aren't any different in kids with ADHD who take
medication compared with those who don't. "

It then says "A June study looked at medication usage and educational outcomes
of nearly 4,000 students in Quebec over an average of 11 years and found that
boys who took ADHD drugs actually performed worse in school than those with a
similar number of symptoms who didn't. Girls taking the medicine reported more
emotional problems, according to a working paper published on the website of
the National Bureau of Economic Research, a nonprofit economics research
firm."

Nowhere, does it say they study studied _kids with ADHD_ , only _kids taking
ADHD drugs_.

I could entirely believe it does not improve grades or cognition in students
who are not actually ADHD, but believe it "helps them focus" or whatever.

THe article seems to mix up these things all over the place, in some cases
talking about ADHD kids, and in some cases talking about kids taking ADHD
drugs.

If the study really only studied kids with some verified accurate ADHD
diagnosis, it would be nice to know that.

While, back when I was diagnosed 27 years ago, kids taking ADHD drugs and kids
with ADHD were likely much the same group of people, they haven't been for a
long time.

------
beachstartup
[http://www.aasa.org/SchoolAdministratorArticle.aspx?id=5642](http://www.aasa.org/SchoolAdministratorArticle.aspx?id=5642)

article on the feminization of schools. boys (even those without learning
'disabilities' are not set up to succeed in 21st century school systems.

------
mistercow
Science reporting in the news sure is broken. Do enough studies and eventually
you'll happen upon one that gives the wrong (and newsworthy) answer, just by
chance.

Here are some studies asking the same question that weren't mentioned, and
their reported effect on academic performance (in order of my encountering
them on scholar.google.com):

1\.
[http://psycnet.apa.org/journals/pha/9/2/163/](http://psycnet.apa.org/journals/pha/9/2/163/)
(positive)

2\.
[http://psycnet.apa.org/journals/ccp/70/2/320/](http://psycnet.apa.org/journals/ccp/70/2/320/)
(positive)

3\.
[http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.1993....](http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.1993.tb01071.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false)
(positive)

4\.
[http://psycnet.apa.org/psycinfo/1993-46419-001](http://psycnet.apa.org/psycinfo/1993-46419-001)
(positive in short term, neutral in long term)

5\.
[http://link.springer.com/article/10.1007/BF00925819](http://link.springer.com/article/10.1007/BF00925819)
(positive)

I stopped there, but I think the trend is obvious. One thing I think is worth
noting is that the short-term studies very directly measure academic
performance by actually observing the patients. The long-term study cited in
TFA - and I suspect most other long-term studies - relied on questionnaires
instead. It seems probable to me that the problem here is that questionnaires
are simply too noisy an information source to obtain a statistically
significant result, given the additional noise created by overdiagnosis.

------
bayesianhorse
ADHD is both over-treated as well as under-treated. Some children might not
need medication, but others suffer from the effects of untreated ADHD.

It often looks as if the side effects of Ritalin are overstated, and the
negative effects of untreated ADHD are understated. ADHD has been linked to
Depression and poor social life.

------
noone55
I am currently prescribed Concerta 54 mg and take it in spurts. Why spurts? A
love-hate relationship. While I am on Concerta, I excel at my job.
Unfortunately, Concerta tends to super-enhance my "logical/work" side while
hampering my "interpersonal/compassion" side. My girlrfriend cannot stand me
while I am on my ADD medication: I am far too distant and non-communicative
with her. I know she is right, I can't deny the truth: I neglect her to focus
on logical tasks instead.

It seems I cannot maintain a healthy, _intimate_ relationship with my
girlfriend (or likely any other person) while on ADD medication. In addition,
my performance at work is abysmal without medication: I find any and every
distraction around me when not medicated. How can I balance my work/personal
life with ADD?! This frustration is driving me crazy! =(

------
1a2a3afou
I went from failing math classes to a straight A student and AIME competitor
after starting concerta in high school. I'm very surprised at the results of
the study. I didn't like the medications either since it made me feel very
strange and I couldn't sleep at all so I tried for a long time to convince my
parents they weren't doing anything.

I'm aware that I act very different while on medication, people around me can
very easily tell whether I forgot to take meds that day.

------
JJ216216
The data used in making this statement is utterly skewed. I defer to Kuhn to
explain why - how many variables were accounted for in any study supporting
this conclusion? This doesn't have to be epistemologically far removed - there
are real variables I'm sure were not accounted for. For example, the DEA has
been on campaign for 2 years to subvert the FDAs authority - where exactly did
funding come from and by whom? Also, one has to consider the rapidly shifting
economic climate we live in - certainly that would have an effect on
performance if it is weighing on a student's mind... Problems with the scope
and geolocation of participants are clear. And the article writer forgot to
address what is placed at the end of every published scientific study - it's
limitations and how the study could have been better. And then there still are
all those epistemological problems (infinite variables) still sitting there,
glaring....

------
joshmn
I wouldn't say they boost grades, but they did allow me to actually finish my
homework (or start, in most cases)

------
aaron695
What sort of parents don't put their kids on medication even though it makes
their lives easier?

One they are probably hippies, but two I'd say they are quite invested in
their child.

Which to me could mean they put in enough extra effort to keep their kids
grades high.

I'd view the study cautiously.

------
linohh
What's the point in this? Of course the stuff doesn't boost grades by itself.
It enables kids and adults to work for school or university or whatever like
someone "normal". It doesn't increase your motivation, it increases your
ability.

------
codex
It's possible that ADHD drugs don't boost grades, on average, because grades
are a strong function of the home environment. Thus, improving a child's focus
without improving their home environment won't magically improve their grades.
Work is work and there is always something more stimulating a child could be
doing in an unstructured environment. ADHD is heritable, so it's possible some
parents don't themselves have strong study skills or discipline, value grades,
and/or have self selected to take the easy route (drugs) before trying the
hard route.

------
hankcharles
A couple questions for those that have been on any single medication for a
sustained period: 1 Have you found that you need to increase your dosage at a
stable rate to maintain the same effectiveness? 2 How are you now when you are
off the medication e.g If you are on vacation and do not need to 'buckle down'
do you still feel a need to take the medication just to feel like yourself?
Thanks in advance for any replies.

------
tsotha
Outside of a tiny percentage of people with a problem serious enough to
warrant medication, the point of the drugs is to make kid easier to manage.

------
tibbon
Maybe not, but I can code 10x better on Adderall. If I had this in high
school, I'd have gone to MIT.

------
scotty79
> If its drugs demonstrably improve attention, focus and self-control, why
> wouldn't grades improve as well?

Because academic performance depends far more on luck than on skill. That's
why the whole standardized testing is silly. It precisely measures pretty much
random variable.

~~~
frozenport
Nope, then good grades wouldn't be repeatable!

------
tekalon
If a kid is taking the meds just for the grades, that's wrong. But ask the
parents/teachers if they are paying attention and remembering instructions
better if they do (which often have a impact on grades).

------
dschiptsov
The same way a better engine oil don't help distracted drivers.)

------
blueprint
Of coures not. Those drugs don't address the root cause.

~~~
TeMPOraL
Which are unknown, might be (currently) unfixable, and more than likely are
completely irrelevant.

One of the reasons Cognitive-Behavioral Therapy states is for it being
effective is essentially ignoring the "root causes" (that may as well be
already gone) of problems in favour of actually fixing it.

~~~
blueprint
They may be unknown to you, but that doesn't mean the causes themselves are
unknown.

In order to find the root cause of a phenomenon, you must point out the
phenomenon concretely enough - you need to know what you are diagnosing.
That's the first step.

Then we need to look at cases.

It's foolish to try to say the causes are unknown without discussing these
concrete matters.

------
paul9290
No but they do boost Pfizer's stock price!

Placebos are a billion dollar business!

