| A dose-response study of OROS methylphenidate in children with attention-deficit/hyperactivity disorder. | |
| | |
MedLine Citation:
|
PMID: 14595084 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: OROS methylphenidate HCL (MPH) is a recently developed long-acting stimulant medication used to treat attention-deficit/hyperactivity disorder (ADHD). This study was conducted to examine dosage effects on ADHD symptoms and stimulant side effects and to explore potential moderating effects of ADHD subtype. METHODS: Children with ADHD combined type (ADHD-CT) or predominantly inattentive type (ADHD-PI; n = 47), ages 5 to 16 years, underwent a placebo-controlled, crossover trial using forced titration with weekly switches at 3 dosage levels. Parent and teacher ratings of ADHD symptoms were used to evaluate efficacy. In addition, vital signs and standardized measures of stimulant side effects were obtained weekly. RESULTS: Parent ratings were more sensitive to treatment effects than teacher ratings. ADHD symptoms and Clinical Global Impressions Severity Index ratings at each dose condition differed significantly from placebo and baseline ratings, which did not differ from one another. For those with ADHD-CT, there was a clear linear dose-response relationship, with clinically significant reductions in ADHD Rating Scale-IV scores occurring in two thirds to three fourths of the subjects during either 36- or 54-mg dose conditions. Children with ADHD-PI, conversely, were more likely to respond optimally to lower doses and derived less benefit from higher doses, with 60% displaying significant improvement on the ADHD Rating Scale-IV at 36 mg or lower. Mild stimulant side effects were reported during placebo and at all dosage levels. With the exception of insomnia and decreased appetite, which were more common at higher doses, parent report of side effects was not related to dose. In addition, younger and smaller children were more likely to display sleep difficulties and decreased appetite at the higher dose levels Although pulse rate increased slightly with increasing dose, there were no dose effects on blood pressure. CONCLUSIONS: In children with ADHD-CT, the most common subtype of ADHD, increasing doses of stimulant medication were associated with increased improvement of inattention and hyperactivity symptoms. In children with ADHD-PI, symptom improvement occurred at lower doses and less benefit was derived from higher doses. In both ADHD subtypes, higher doses were associated with parent ratings of increased insomnia and decreased appetite. |
| | |
Authors:
|
Mark A Stein; Christopher S Sarampote; Irwin D Waldman; Adelaide S Robb; Charles Conlon; Phillip L Pearl; David O Black; Karen E Seymour; Jeffrey H Newcorn |
Related Documents
:
|
11186094 - Effects of small dose of brotizolam on p300. 7970014 - A double-blind, placebo-controlled trial of tizanidine in the treatment of spasticity c... 18779774 - The efficacy and tolerability of once-daily extended release quetiapine fumarate in hos... 23013044 - Validation of two elisa kits for the screening of tylosin and streptomycin in honey acc... 3144524 - Effect of ciprofloxacin in an in-vitro pharmacokinetic model against pseudomonas aerugi... 11473654 - Vasopeptidase inhibition attenuates the progression of renal injury in subtotal nephrec... |
Publication Detail:
|
Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Pediatrics Volume: 112 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2003 Nov |
Date Detail:
|
Created Date: 2003-11-03 Completed Date: 2003-11-25 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
|
Languages: eng Pagination: e404 Citation Subset: AIM; IM |
Affiliation:
|
Department of Psychiatry, University of Chicago, Chicago, Illinois 60637, USA. mstein@yoda.bsd.uchicago.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Attention Deficit Disorder with Hyperactivity / drug therapy* Central Nervous System Stimulants / administration & dosage, adverse effects, therapeutic use* Child Child, Preschool Cross-Over Studies Delayed-Action Preparations Dose-Response Relationship, Drug Eating Disorders / chemically induced Female Humans Male Methylphenidate / administration & dosage, adverse effects, therapeutic use* Parents / psychology Patient Compliance Severity of Illness Index Sleep Initiation and Maintenance Disorders / chemically induced Teaching Tics / chemically induced |
| Grant Support | |
ID/Acronym/Agency:
|
K24MHO1823/MH/NIMH NIH HHS; M01-RR13297/RR/NCRR NIH HHS; MH19833-04/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Central Nervous System Stimulants; 0/Delayed-Action Preparations; 113-45-1/Methylphenidate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Childhood cancer among Alaska Natives.
Next Document: Low glycemic index breakfasts and reduced food intake in preadolescent children.