ADHD Medication & Treatment

Dear Mr. Kennedy

The science is clear: ADHD is a genetic condition whose expression is muted or amplified by environmental factors. Medication is the most effective treatment for ADHD symptoms, and it works best when augmented with behavioral therapy, exercise, clean nutrition, and adequate sleep.

By Anni Layne Rodgers Updated on May 22, 2025
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Calls to Action: MAHA Commission Testimony & Advocacy

February 26, 2025

Dear Secretary Kennedy,

As the Make America Healthy Again Commission begins its evaluation of published research on the chronic health conditions impacting American children, we urge it to consult with the esteemed clinicians associated with the American Professional Society of ADHD and Related Disorders (APSARD), the American Academy of Pediatrics (AAP), and the World Federation of ADHD regarding the established science on ADHD causes and treatments. Consensus within these groups, and among ADHD researchers worldwide, is strong and consistent regarding the following evidence-based findings:

  • ADHD is a chronic neurodevelopmental condition characterized by inattention, impulsivity, executive dysfunction, and/or hyperactivity that persists into adulthood for approximately 90% of patients.1
  • ADHD is a highly genetic condition.2,3,4 Lifestyle factors such as nutrition, exercise, and sleep exert epigenetic changes on DNA that influence how strongly or weakly ADHD genes are expressed. However, diet, physical activity, sleep, or screen use alone do not cause — and have not been shown to “cure” — ADHD.
  • The 16% increase in ADHD diagnoses over the last decade is due, in large part, to revised diagnostic criteria published in the DSM-5, which changed the maximum age of onset from 7 to 12 and added the first-ever qualifier symptoms for ADHD in adulthood. This wider net, along with improved education, training, and symptom recognition, particularly in historically overlooked girls and women, account for much of the diagnostic uptick, according to studies.5, 6
  • Scientific research has established no causal link between excessive screen time, video game play, or social media use  and ADHD.7 Some studies suggest these habits may exacerbate inattention and impulsivity.8, 9
  • Scientific research has established no causal link between consumption of sugar, food additives, or food dyes and ADHD, though some studies show a heightened sensitivity among children with ADHD to these foods, which may exacerbate existing symptoms.10
  • Scientific research shows that prenatal and/or childhood exposure to tobacco, lead, pesticides, and polychlorinated biphenyls (PCBs) may increase the odds of ADHD in some children, however the studies do not find direct causality.11,12, 13,14
  • Several research studies have shown that consumption of a Western diet high in processed foods, fats, sugars, and salt is associated with higher rates of ADHD, however these studies demonstrate an association rather than causality.15
  • ADHD shortens an individual’s life expectancy by 7.5 years, on average.16 It is serious, potentially lethal, and associated with elevated risks for comorbid conditions 17, 18 including anxiety, depression,19 substance use disorder,20 eating disorders,21, 22 obesity, and oppositional defiant disorder,23 which commonly derails treatment plans and parenting strategies. People with ADHD are more likely to get into car accidents,24 become hospitalized, and engage in self-harm than are their neurotypical peers.25, 26, 27
  • In patients with the condition, ADHD medication use reduces the risk of death by 19%, the risk of overdose by 50%,28 the risk of substance abuse by 50%,29 and the risk of motor vehicle accidents by at least 38%.30 Its effective symptom management improves patients’ self-esteem and efficacy, thereby reducing the risk of self-harm and suicide, as well as negative life outcomes such as unwanted pregnancy, incarceration, unemployment, and interruption of education.
  • The medications used to treat ADHD have been studied rigorously and used safely for 88 years. Amphetamine and methylphenidate safely and effectively reduce ADHD symptoms, with methylphenidate reducing symptoms by 70% to 90% in children and adults with the condition.31, 32 The effect sizes for ADHD medication are .8 to 1.0,33  which are among the strongest in all of psychiatry. Clinical practice guidelines recommend medication as the first-line treatment for ADHD due to its overwhelming efficacy; for children with ADHD ages 4 to 6, parent behavior training is recommended by the AAP.34
  • According to the CDC, just 53.6% of all children and teens with ADHD reported they were actively treating their symptoms with medication in 2022. Because stimulant medications are classified as Schedule II drugs under the Controlled Substances Act, they are tightly regulated; supplies are limited to 30 days and prescribing clinicians must authorize monthly refills. The widely reported ADHD medication shortage has disrupted treatment for millions of patients across the country since 2022.35
  • Caregivers and adults with ADHD surveyed by ADDitude rate medication as the most effective treatment for ADHD, however less than half of parents report that they chose to medicate their children within 6 months of diagnosis. They report changing diet, limiting screen time, supplementing with fish oil, and increasing physical activity before ultimately using medication to achieve the symptom improvement necessary for academic and social success.
  • The mild to moderate side effects associated with ADHD medication include appetite suppression, irritability or moodiness, sleep problems, and headaches. There is no evidence that ADHD medication use leads to dependency or broader substance abuse; in fact, research shows that ADHD medication use is protective against substance use disorder in individuals with ADHD.36
  • The non-stimulant medications used to treat ADHD, such as atomoxetine, guanfacine, and clonidine, have an effect size of .4 to .7 and are considered a second-line treatment appropriate for patients who do not tolerate or cannot take stimulants.37, 38, 39
  • Clinical guidelines promote the use of multimodal treatment plans that pair prescription medication with complementary approaches to ADHD management. The nonpharmacological interventions shown to be most effective at reducing ADHD symptoms in children are behavioral therapy (effect size of .5 to.8 when used on its own),40 exercise (effect size of .4 to .6 when used on its own),41 sleep hygiene and interventions (effect size of .5 to .8 when used on their own),42 and dietary interventions (effect size of .2 to .5 when used on their own).43
  • Behavioral therapy, principally parent training, has an elevated and improved effect when used in conjunction with ADHD medication.44 Behavioral therapy is used by just 44% of pediatric patients, in part because it’s not always covered by medical insurance and knowledgeable providers are scarce.
  • One meta-analysis of randomized, placebo-controlled trials showed that supplementation with high doses of omega-3 fatty acids has a small positive impact on attention and hyperactivity in children.45
  • Research suggests that restricting the consumption of synthetic food dyes does benefit some children with ADHD, though aggregate effects are quite small.46
  • When engaging in vigorous cardiovascular exercise, the brain releases endorphins. Levels of dopamine, norepinephrine, and serotonin also increase with exercise, thus improving focus, working memory, and mood to enable better learning.
  • Cognitive behavioral therapy (CBT), though more commonly prescribed to adult patients, has been shown to improve core ADHD symptoms in adolescents when used in conjunction with ADHD medication.47
  • Neurofeedback uses an electroencephalogram (EEG) to measure brain activity and train the patient to produce brain wave patterns like those of a non-ADHD brain. Neurofeedback has not shown enough effectiveness in studies to be recommended as a “stand-alone” treatment for ADHD and there is little evidence that neurofeedback reduces ADHD symptoms long-term. In addition, neurofeedback is seldom covered by insurance and involves a significant investment of time and money.48, 49, 50
  • According to research, brain training does not reduce ADHD symptoms. There is no evidence that a patient can train a brain to improve working memory, or any other executive function.51, 52, 53

Thank you for reviewing the evidence-based research highlighted above. We welcome follow-up questions from the Commission as it devises recommendations based on science that may benefit the health and wellbeing of the 22 million Americans with ADHD, whom ADDitude has served for the last 26 years. We support their personal liberty to pursue and maintain the treatments that benefit their ADHD brains, which are a tremendous asset to this nation.

Sincerely,
Anni Rodgers
General Manager, ADDitude

View Article Sources

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2Faraone, Stephen V. et al. Molecular Genetics of Attention-Deficit/Hyperactivity Disorder, Biological Psychiatry, Volume 57, Issue 11, 1313 – 1323

3Liuyan Zhang, Suhua Chang, Zhao Li, Kunlin Zhang, Yang Du, Jurg Ott, Jing Wang, ADHDgene: a genetic database for attention deficit hyperactivity disorder, Nucleic Acids Research, Volume 40, Issue D1, 1 January 2012, Pages D1003–D1009, https://doi.org/10.1093/nar/gkr992

4Gizer, I.R., Ficks, C. & Waldman, I.D. Candidate gene studies of ADHD: a meta-analytic review. Hum Genet 126, 51–90 (2009). https://doi.org/10.1007/s00439-009-0694-x

5Mowlem, F.D., Rosenqvist, M.A., Martin, J. et al. Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. Eur Child Adolesc Psychiatry 28, 481–489 (2019). https://doi.org/10.1007/s00787-018-1211-3

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8Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr. 2019;173(3):244–250. doi:10.1001/jamapediatrics.2018.5056

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52 Chacko, A., Bedard, A. C., Marks, D. J., Feirsen, N., Uderman, J. Z., Chimiklis, A., Rajwan, E., Cornwell, M., Anderson, L., Zwilling, A., & Ramon, M. (2014). A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition. Journal of child psychology and psychiatry, and allied disciplines, 55(3), 247–255. https://doi.org/10.1111/jcpp.12146

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