Attention Deficit Pays at Shire

Still, Pelham has battled to make his views known. Following the first Concerta trial, he says, Alza "wanted whole paragraphs cut out" of a journal article that highlighted the role of behavioral therapy in treatment. Pelham ultimately won his fight to retain the material, but he believes that other researchers -- without his stubbornness or seniority -- often feel pressured enough to back down instead.

"That pressure, whether it is subtle or not so subtle, is always something you have to deal with," he says. "The drug companies want to emphasize medications. That is what they are selling."

Catching Conflicts

LeFever's research could hurt that goal.

So far, her opponents have only managed to nitpick. For example, they pounced on the wording of a single question in one of her studies even though it failed to influence her overall results. They also highlighted research that showed much lower ADHD rates instead of more recent studies that helped support her work.

Still, LeFever has felt herself battling an unimaginable force.

Russell Barkley -- a high-profile expert known to embrace the ADHD drugs -- emerged with his familiar argument that, if anything, even more children should be medicated for the disorder. His recent "Without Boundaries" survey was spearheaded in 2004 by the World Federation for Mental Health, in partnership with Eli Lilly.

Donald Lewis, a pediatrics professor at LeFever's own medical school, also took aim at LeFever's work. Lewis did not respond to a phone message from TheStreet.com. But like many researchers, he could be answering to more than one boss. The school's directory says that Lewis actually works for nearby Monarch Research. Notably, Monarch counts dozens of drug manufacturers among its "collaborators" -- including Alza, Eli Lilly, Novartis and Shire -- and currently operates four clinical studies on ADHD treatments alone.