by michelle coppedge

Your child has trouble paying attention in school. She's hyperactive and impulsive. Her doctors say her symptoms are long term — that she suffers from Attention Deficit Hyperactivity Disorder (ADHD). She needs medication to solve her problems, right?

Maybe not. A recent study finds that some children with ADHD do just as well when some of their medication is replaced with placebos. James Bodfish, professor in the Department of Psychiatry at the School of Medicine, worked with Adrian Sandler, a developmental-behavioral pediatrician at the Mission Children's Hospital in Asheville, in a study of twenty-six children aged seven to fifteen.

The children received their usual dose of stimulant medication, the amount that kept their ADHD symptoms under control. Then they received half that dose, both with and without a placebo, in alternating weeks. Parents, teachers, and clinicians found that forty percent of the children behaved no differently under the low-dose-plus-placebo treatment than they did under the full dose. In addition, both parents and children were fully informed about the study. Even when they knew they were taking less medication, the children responded well.

Some parents decide not to treat their children for ADHD due to concerns about the side effects sometimes associated with stimulant medications, Bodfish says. However, these concerns may soon diminish. "Our preliminary findings suggest that conditioned placebo treatment may allow some children to be effectively treated on lower doses of medication and experience fewer side effects," Bodfish says.

The results of this study, which Sandler and Bodfish presented at the annual meeting of the Pediatric Academic Societies in May, 2003, led to a grant from the National Institute of Mental Health to further investigate the effects of placebos on ADHD. Sandler's and Bodfish's current two-year study involves 150 children.

Michelle Coppedge is editorial assistant for Endeavors magazine.