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Do Meds Enhance Improvements from Cognitive-Behavioral Tx in Adults with ADHD?

18 Feb

Researchers from the University of British Columbia in Vancouver BC looked at the efficacy of Cognitive Behavioral Therapy for adults with ADHD, while controlling for medication use.
Previous studies had not controlled for meds status and included either medicated participants or mixed samples of medicated and unmedicated subjects.  So the objective of this study was to examine whether the use of medication actually improves the outcome of CBT, which is known to be helpful.

The investigators used a secondary analysis comparing 23 participants randomized to CBT and Dextroamphetamine vs. 25 participants randomized to CBT and placebo. Both patients and investigators were blind to treatment assignment. Two co-primary outcomes were used: ADHD symptoms on the ADHD-RS-Inv completed by the investigator; and improvement in functioning as reported by the patient on the Sheehan Disability Scale.

Analysis revealed that both groups showed robust improvement in both symptoms and functioning, but the use of medication did not significantly improve outcome over and above use of CBT and placebo.

This study replicates previous work demonstrating that CBT is an effective treatment for ADHD in adults. Within the limits of this pilot, secondary analysis failed to demonstrate that medication significantly augments the outcome of CBT therapy for adults with ADHD.

The study was funded by GlaxoSmithKline, Clinical Trials Registry #GSK707.  The full report is available here:

Citation:  Weiss M, Murray C, Wasdell M, Greenfield B, Giles L, Hechtman L A randomized controlled trial of CBT therapy for adults with ADHD with and without medication.  BMC Psychiatry. 2012 Apr 5;12:30. doi: 10.1186/1471-244X-12-30. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award