An updated review pulled together about 15 years of research on treating ADHD in adolescents. It included 53 studies published between 1999 and 2012. All the young people were aged 10.0 to 19.9 years and met the criteria for ADHD. The studies covered 17 controlled medication trials, 22 behavior therapy studies, and three studies of cognitive enhancement training such as working memory training and neurofeedback.
Medication and behavior therapy produced a similar overall range of benefits. Medication had the largest effect on ADHD symptoms (d=.64). Behavior therapy had the largest effect on day-to-day impairment, especially schoolwork (d=1.20). Medication's effect on academic impairment was smaller (.56). Cognitive enhancement training showed almost no effect on symptoms (d=.06) and no sign of improving functioning.
The authors note the evidence does not support treatment guidelines that name stimulants as the preferred choice for adolescents.
The review had limits. Only six of the medication trials (35.3%) measured impairment at all. Most of the medication trials (58.8%) were funded by industry. The samples were mostly White and male. In the psychosocial studies, most were White (86.4%). Nearly all were male (90.9%). Most medication diagnoses came from parent report alone.
Anyone weighing treatment for an adolescent should talk with a clinician about their own situation.
Source: Sibley M, Kuriyan A, Evans S, et al.. Pharmacological and psychosocial treatments for adolescents with ADHD: An updated systematic review of the literature. Clinical Psychology Review (2014). doi:10.1016/j.cpr.2014.02.001
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