Drug treatment benefited children in the amount of school work that they completed , by up to 15 % , and less consistently improved children ’s accuracy in specific types of academic assignments , such as arithmetic .
Methylpheni date , dexamfetamine and mixed amfetamine formulations all showed beneficial effects on children ’s on-task behaviour and academic work completion .
These review findings suggest that medication for ADHD has the potential to improve children ’s learning and academic achievement
Attention-deficit hyperactivity disorder ( ADHD ) has a significant impact on children ’s classroom behaviour , daily functioning and experience of school life .
However , the effects of drug treatment for ADHD on learning and academic achievement are not fully understood .
This review was undertaken to describe the effects of methylpheni date , dexamfetamine , mixed amfetamine salts and atomoxetine on children ’s on-task  behaviour and their academic performance , and to perform a meta- analysis to quantify these effects .
A Comparison of Ritalin and Adderall: Efficacy and Time-course in Children With Attention-deficit/Hyperactivity Disorder
Objective . Very little research has focused on the efficacy of Adderall ( Shire-Richwood Inc , Florence , KY ) in the treatment of children with attention-deficit/hyperactivity disorder ( ADHD ) , and no studies have compared it with st and ardized doses of Ritalin ( Novartis Pharmaceuticals , East Hanover , NJ ) . It is thought that Adderall has a longer half-life than Ritalin and might minimize the loss of efficacy that occurs 4 or 5 hours after Ritalin ingestion . We compared two doses of Ritalin and Adderall in the treatment of ADHD in children in an acute study and assessed the medications ' time courses . Design . Within-subject , double-blind , placebo-controlled , crossover design lasting 6 weeks . As in our previous work , medication changes occurred on a daily basis in r and om order over days . Setting . Eight-week , weekday ( 9 hours daily )  summer treatment program at the State University of New York at Buffalo , using an intensive behavioral treatment program including a point system and parent training . Study Participants . Twenty-five children ( 21 boys and 4 girls ) diagnosed as ADHD using st and ardized structured interview and rating scales , mean age 9.6 years , 88 % Caucasian , of average intelligence , with no medical conditions that would preclude a trial of stimulant medication . Thirteen were comorbid for opposi-tional-defiant disorder and another 8 for conduct disorder . Interventions . Children received 10 mg of Ritalin , 17.5 mg of Ritalin , 7.5 mg of Adderall , 12.5 mg of Adderall , or placebo , twice a day ( 7:45 am and 12:15 pm ) , in r and om order with conditions changing daily for 24 days . Outcome Measures . Daily rates of behaviors in recreational and classroom setting s , and st and ardized ratings from counselors , teachers , and parents , were averaged across days within condition within child and compared . Within-subject relative sizes of the medication effects were computed by taking the placebo-minus-drug mean difference divided by the placebo st and ard deviation for each child , and were compared hourly between first daily ingestion ( 7:45am ) and 5:00 pm to assess the time course of the two drugs . Measures were taken at 12:00 pm ( recess rule violations ) and at 5:00 pm ( parent behavior ratings ) to determine whether Adderall was still effective at times when the effects of Ritalin should have worn off . Parent ratings were also made for evening behavior to assess possible rebound , and side effects ratings were obtained from parents , counselors , and teachers . Parents , counselors , and teachers also rated their perceptions of medication status and whether they recommended the continued use of the medication given that day . Finally , a clinical team made recommendations for treatment taking into account each child 's individual response . Results . Both drugs were routinely superior to placebo and produced dramatic improvements in rates of negative behavior , academic productivity , and staff/parent ratings of behavior . The doses of Adderall that were assessed produced greater improvement than did the assessed doses of Ritalin , particularly the lower dose of Ritalin , on numerous but not all measures . This result suggests that the doses of Adderall used were functionally more potent than those for Ritalin . Adderall was generally superior to the low dose of Ritalin when the effects of Ritalin were wearing off at midday and late afternoon/early evening . The lower dose of Adderall produced effects comparable to those of the higher dose of Ritalin . Both drugs produced low and comparable levels of clinical ly significant side effects . Staff clinical recommendations for continued medication favored Adderall three to one . Almost 25 % of the study participants were judged to be nonresponders by the clinical team , presumably because of their large beneficial response to the concurrent behavioral intervention and minimal incremental benefit from medication . Conclusions . This is the first investigation to assess comparable doses of Adderall and Ritalin directly . Results showed that Adderall is at least as effective as Ritalin in improving acutely the behavior and academic productivity of children with ADHD . These results show clearly that Adderall should be added to the armamentarium of effective treatment for ADHD , particularly for children in whom the effects of Ritalin dissipate rapidly and a longer acting medication is desired . Measures taken at times of the day when Ritalin is expected to have worn off—4 to 5 hours after ingestion — generally showed that Adderall was more effective than Ritalin at these times . The 7.5-mg twice-a-day dose of Adderall and the 17.5-mg twice-a-day dose of Ritalin produced equivalent behavioral changes . This indicates that a 5-mg dose of Adderall ( or slightly less ) is equivalent to a 10-mg dose of Ritalin , indicating that Adderall is twice as potent ; this potency ratio is similar to the well-known 1:2 ratio between d-amphetamine and methylpheni date . A higher dose of Adderall did not produce incremental improvement beyond that of the 7.5-mg dose , and parents were less likely to desire the continuation of the higher Adderall dose than the other medication conditions . Three-quarters of the responders to medication were recommended the lower rather than higher of the doses assessed . These findings are similar to our previous reports that there is a diminishing incremental value with stimulant medications beyond low to moderate doses , particularly when a behavioral intervention is concurrently implemented . Time-course results indicated that the afternoon dose of medication seemed to have a larger effect than the morning dose , raising the possibility that afternoon doses of stimulant medication may be able to be reduced relative to the morning dose without a corresponding reduction in efficacy . Although this practice is commonly used with some cases in clinical setting s , it is almost never used in empirical investigations and no studies have systematic ally investigated the practice . Our results suggest that systematic studies of a reduced midday dose are indicated . Further studies of dose equivalence and dose-response , including mg/kg dosing rather than absolute dosing , are necessary to firmly establish the  Adderall : Ritalin  dosing ratio and guidelines for clinical practice . Studies comparing Adderall to d-amphetamine should be conducted to determine whether the compound is superior to d-amphetamine alone . Further examinations of time-course are necessary to determine the length of action of  Adderall  — for example , whether a single morning dose will be sufficient to provide coverage throughout the school day
Drug treatment benefited children in the amount of school work that they completed , by up to 15 % , and less consistently improved children ’s accuracy in specific types of academic assignments , such as arithmetic .
Methylpheni date , dexamfetamine and mixed amfetamine formulations all showed beneficial effects on children ’s on-task behaviour and academic work completion .
These review findings suggest that medication for ADHD has the potential to improve children ’s learning and academic achievement
Attention-deficit hyperactivity disorder ( ADHD ) has a significant impact on children ’s classroom behaviour , daily functioning and experience of school life .
However , the effects of drug treatment for ADHD on learning and academic achievement are not fully understood .
This review was undertaken to describe the effects of methylpheni date , dexamfetamine , mixed amfetamine salts and atomoxetine on children ’s on-task  behaviour and their academic performance , and to perform a meta- analysis to quantify these effects .