2017 ADHD Treatment Survey Findings
A recent ADDitude magazine survey of more than 4,000 caregivers and adults shows they use personalized, nuanced combinations of ADHD treatment strategies that extend well beyond stimulant medications, the most commonly recommended option among clinicians. It also shows that ADHD treatment is a moving target that shifts with time, costs, availability, side effects, and more.
NEW YORK, October 23, 2017 – ADDitude magazine, a publication founded in 1998 to inform and connect individuals and families living with attention deficit disorder (ADHD), today announced the results of its groundbreaking survey of 4,425 caregivers and adults regarding their ADHD treatment research, strategies, and satisfaction. Read the full survey report here. ADDitude deployed its survey to more than 90,000 newsletter subscribers; the 4,425 people who responded reported the demographic profile, ADHD diagnosis timeline, and chief symptoms outlined in the chart below.
Profile of ADHD Treatment Survey Respondents
|Average Age When Diagnosed||8 years||39 years|
|Average Years Since Diagnosis||4.4 years||5.3 years|
|Main Symptoms Being Treated|
|. Organization challenges||60%||81%|
|. Time management challenges||57%||82%|
|. Intense or fluctuating emotions||52%||55%|
|. Sleep disturbances||30%||42%|
|. Other executive function challenges||43%||52%|
|. Social skills deficits||50%||33%|
|. Difficult behavior||48%||12%|
In the survey, respondents were asked to report all of the treatment strategies used currently — and in the past — to address symptoms of ADHD in themselves or their child. An overwhelming majority of individuals with ADHD — 67% of children and 70% of adults — report using prescription medication, which was recommended or prescribed by 92% of respondents’ doctors. The most commonly used medications among children with ADHD were Concerta (42% of respondents had ever used it), Adderall (38% had used it), and Vyvanse or Ritalin (both tried by 32%). Adderall, Ritalin, and Vyvanse were the most commonly used among adults with an ADHD diagnosis.
Few respondents said they found the best medication on their first try. In fact, 44% of caregivers and 45% of adults said they had ever stopped administering or taking a prescription medication. On average, caregivers reported trying 2.7 different prescriptions before finding one that helped their child manage symptoms with minimal side effects. Adults with ADHD, on average, said they tried 3.5 different medications before finding an effective solution. The most common side effects cited by both demographics were loss of appetite, irritability, and sleep disturbances.
ADHD Medication Side Effects
|Top 3 Side Effects Ever Experienced||Children||Adults|
|Loss of appetite||58%||35%|
Potential or actual side effects weigh heavily on caregivers’ minds as they decide whether to give their child an ADHD medication, according to respondents’ comments. In a follow-up survey of 317 individuals, 20% of caregivers said they tried other treatments before turning to medication; 14.5% said they considered medication a “last resort” if no other treatments worked.
“My husband and I were very reluctant to try medication on our son for his ADHD (without hyperactivity),” wrote one caregiver. “We actually refused to give him any medication and tried our own treatments options (diet, supplements, specialists, sports). But, when they did not work and our son was failing in class and struggling with extremely low self-esteem, we had to at least try the medication. Vyvanse has worked great for him and he has even thanked us for giving him something to remove all the cobwebs in his brain.”
Despite anecdotal accolades such as this and its relative ubiquity in treatment plans, ADHD medication received a lackluster satisfaction rating among both the caregivers and adults who answered our survey. Though overall satisfaction with medication was higher among adults than caregivers, it did not top 50% for either segment.
ADHD Medication Ratings
|Attitudes Toward Medication||Caregivers||Adults|
|ADHD medication has been a life-changer||45% Agree||50% Agree|
|ADHD medication has some positives and some negatives||45% Agree||45% Agree|
|We thought of medication as a “first-line” treatment||16% Agree||34% Agree|
|Medication is just part of a treatment plan||40% Agree||21% Agree|
“It’s always a balancing act. As he grows — and now that he is [going through] puberty — medication always needs to be watched and nuanced,” wrote one caregiver. “I hate the flattening of the personality, but I would never get him through school (without medication) and he is very smart. I feel as if I have no choice but to medicate because the alternative seems a way worse way to go.”
According to the survey responses, medical professionals were far less likely to recommend alternatives to medication. For example, the next most commonly prescribed treatment after medication was cognitive behavioral therapy (CBT); 47% of respondents who used this treatment reported that it was recommended by a doctor.
“ADHD is overwhelming as it is,” wrote one caregiver. “Lack of evidence, costs, time, not enough support from practitioners makes non-medication treatments overwhelming and sometimes not realistic. There is a need for practitioners to help guide parents through the non-medication options.”
Despite a dearth of clinicians’ recommendations, non-medication treatment solutions were commonly used among survey respondents. The most popular among caregivers were exercise (used by 37% of families); vitamins, minerals, or supplements (used by 36%); and diet or nutrition plans (used by 29%). Vitamins, minerals, and supplements were the most popular among adults, with 41% of respondents using them to address symptoms of ADHD. Exercise and mindful meditation were also used by 37% and 35% of adult respondents, respectively.
ADHD Treatment Landscape
|Treatments Currently Being Used||Children||Adults||Recommended by a Doctor?|
|Vitamins, minerals, or supplements||36%||41%||17%|
|Cognitive Behavioral Therapy (CBT)||19%||47%|
|Behavior therapy/parent-training classes||10%||31%|
|Neurofeedback with a clinician||5%||3%||44%|
|Home-based brain training||3%||2%||9%|
Treating ADHD Without Medication
|Vitamins, Minerals, and Supplements Most Commonly Used||Children||Adults|
Treating ADHD with Diet and Nutrition
|Diet/Nutrition Strategies Most Commonly Used||Children||Adults|
|Decreasing/eliminating artificial colors/dyes||70%||53%|
|Decreasing/eliminating artificial sweeteners||56%||53%|
|Decreasing/eliminating artificial flavors||51%||48%|
Most Popular ADHD Treatments
|Treatments Found Extremely or Very Effective||Children||Adults|
|Behavior management/parent-training classes||33%||–|
|Cognitive Behavioral Therapy (CBT)||–||41%|
|Neurofeedback with a clinician||30%||42%|
|Home-based brain training||24%||33%|
|Vitamins, minerals, or supplements||14%||14%|
Least Popular ADHD Treatments
|Treatments Found Not Very or Not At All Effective||Children||Adults|
|Behavior management/parent-training classes||13%||–|
|Cognitive Behavioral Therapy (CBT)||–||16%|
|Neurofeedback with a clinician||27%||26%|
|Home-based brain training||33%||32%|
|Vitamins, minerals, or supplements||42%||34%|
This data shows that no singular medication, therapy, or dietary and supplement plan works for all individuals with ADHD. What’s more, the treatments that our readers told us work the best are not always the same ones recommended by their doctors or used by the most people. For example, ADHD coaching and counseling was the third most effective treatment according to caregivers and adults, however only 26% of children and 21% of adults use it. On the flip side, vitamins and minerals were rated as extremely or very effective by only 14% of survey respondents, yet 36% of children and 41% of adults say they use them to address ADHD symptoms.
Though stimulant medications remain the most commonly recommended and prescribed treatment for ADHD symptoms, only about half of caregivers and adults say they do an extremely or very good job. Meanwhile, exercise is rated as the most effective treatment option for ADHD yet only 13% of survey respondents said their doctor recommended it.
This disconnect is explained, in part, by the answers to our question: What is the biggest reason why you have not tried treatments other than medication?
ADHD Treatment and the Impact of Insurance, Cost & Availability
|Why Non-Medication Treatments Are Not Used||Children||Adults|
|Not covered by insurance/high cost||29%||28%|
|Hard to find professionals||24%||25%|
|Wasn’t aware of other treatments||11%||22%|
|Medication alone works well enough||10%||20%|
“We stopped due to high costs, lack of insurance, and a lack of providers who understood ADHD,” wrote one caregiver about her child’s behavior-management program. “After a while, you tire of spending $150 just to hear how badly your child behaves.”
These survey results confirm that ADHD is a complex condition with equally nuanced and varied treatment solutions. What works for some patients does not help others, and vice versa. In addition, most caregivers and adults said their treatment plan is constantly changing and shifting alongside hormones, tolerances, and side effects. The job of finding an effective, cohesive treatment plan with more benefits than drawbacks is an ongoing process, this survey suggests.
Quotes from Survey Respondents
“We have learned that treating ADHD is a moving target,” one respondent wrote. “Some things work for awhile and changes occur in adolescence that make it important to alter the treatment plan. A multi-modal approach seems to work best for us.”
“It is overwhelming at times to try to do all of these treatments,” wrote one caregiver. “I feel parents are on their own… We would have benefited from an interdisciplinary team including pediatrician, therapist and teacher meeting once a year at least and have someone coordinate with us throughout the year to check in.”
“The impact of non-medication treatments is not significant, or that hasn’t been the case. Proper nutrition, exercise, and vitamins likely help, however, not enough to control my son’s behavior in a school setting where is when we need it most.”
“It is hard to find professional help in my area. The drive time is 90 minutes round trip, which leaves no time for homework or activities after an hour-long session. We have tried many supplements and they don’t seem to help. Our doctor said it was useless and unproven. I have tried home trainjng programs and parenting programs, bought many books… the stress of dealing with ADHD in my two boys, plus angry teachers, makes it tough to keep up.”
“People take medication for things as little as allergies, headaches, and big things like life sustaining medications so why be ashamed of taking medication for something like achieving focus? Clearly we do not want dependency, which is why meds are only one part of the treatment process but we shouldn’t deny medication its role in treatment.”