The Texas children's medication algorithm project: Report of the Texas consensus conference panel on medication treatment of childhood attention-deficit/hyperactivity disorder. Part I

Objectives: Expert consensus methodology was used to develop evidence-based , consensually agreed-upon medication treatment algorithms for attention-de ficit/hyperactivity disorder (ADHD) in the public mental health sector. Alt hough treatment algorithms for adult mental disorders have been developed, this represents one of the first attempts to develop similar algorithms for childhood mental disorders. Although these algorithms were developed initi ally for the public sector, the goals of this approach are to increase the uniformity of treatment and improve the clinical outcomes of children and a dolescents with ADHD in a variety of treatment settings. Method: A consensu s conference of academic clinicians and researchers, practicing clinicians, administrators, consumers, and families was convened to develop evidence-b ased consensus algorithms for the pharmacotherapy of childhood ADHD. After a series of presentations of current research evidence and panel discussion , the consensus panel met and drafted the algorithms along with guidelines for implementation. Results: The panel developed consensually agreed-upon a lgorithms for ADHD with and without specific comorbid disorders. The algori thms consist of systematic strategies for psychopharmacological interventio ns and tactics to ensure successful implementation of the strategies. While the algorithms focused on the medication management of ADHD, the conferenc e emphasized that psychosocial treatments are often a critical component of the overall management of ADHD. Conclusions: Medication algorithms for ADH D can be developed with consensus. A companion article will discuss the imp lementation of these algorithms.