Parents seeking the best individual drug for their children with attention deficit hyperactivity disorder have little hard evidence to help make that choice.

full article
http://www.emaxhealth.com/37/3328.html

It's a "crap shoot." No one really knows what meds will work for each person;especially kids.

However, the long term track records of stimulants is very positive.

Obviously, this research group needs to do either a lit review or get a bigger sample size if they want sufficient enough (statistical) power to make those data meaningful.

The majority of the head-to-head trials identified by the Oregon reviewers, led by Dr. Marian McDonagh, compared the widely prescribed ADHD medication Ritalin with other drugs. Most of these comparative trials were short in duration, included only a small number of patients and did not measure the long-term effects of the drugs.
This is a problem with many theraputic drugs on the market, not just psychiatric medications; blood pressure medications come to mind. Costly, newer, blood pressure meds have been shown to be equally efficacious for the great majority of people to the old, inexpensive meds.

Pharmaceutical companies who fund the studies are only interested in showing their (newly patented, exclusive) drug to be efficacious. They are not interested in showing that their drug X is better than drug Y in a head to head comparison (except when it comes to comparisons to ritalin, where they can alway compete sucessfully on duration of action; how much money has Shire spent to show amphetamine is longer-acting than ritalin).

Why? Because the company's marketing reps can maintain the superiority (and shiny newness) of the newer drug, without the need for a costly trial, or much evidence beyond what is required for drug approval. In addition, a costly clinical trial may, indeed, show their drug is equal or less efficacious that a known drug which is off-patient, so why would anyone pay more for the new drug.

This makes perfect business sense. Why should a company spend money on uncertain research if the money is better spent on marketing. If a company gets FDA approval for a new drug or drug formulation, their marketing people can gaurentee net market share in a known, large market. Its no surprise that companies spend twice as much on marketing than research.

But this flawed, market-driven process leaves the consumer with little meaningful comparison information. And prescribing physicians are often provided misleading information from the industry.

I'll get off my soap box now:soapbox: