An Open-Label Trial of Methylphenidate Treating Sluggish Cognitive Tempo, Inattention, and Hyperactivity/Impulsivity Symptoms Among 6- to 12-Year-Old ADHD Children: What Are the Predictors of Treatment Response at Home and School?

Abstract

Objective: This study investigated the effects of sluggish cognitive tempo (SCT), other psychiatric symptoms, age, dose, and pretreatment ADHD severity on methylphenidate (MPH) treatment response among ADHD children in both home and school. In addition, the predictors of the MPH-SCT treatment response were examined. Methods: One hundred eighty-five (6–12 years old) ADHD children who were treated with MPH included in the study. Results: MPH improved SCT total and SCT-Daydreaming scores both at home and school while improved SCT-Sluggish scores in only school. Higher pretreatment Daydreaming score predicted lower treatment response for inattention ( B = .301, p = .002), and higher Daydreaming-Sluggish scores predicted lower treatment response for total ADHD symptoms at school ( B = .456, p = .006; B = .888, p = .04, respectively). Also higher oppositional defiant disorder symptoms have negative effects on MPH treatment response in ADHD. Older age positively affected the MPH-SCT treatment response in paternal and teacher ratings. Conclusion: SCT symptoms have negative effects on MPH treatment response at school.

Atomoxetine might be more effective in improving sluggish cognitive tempo symptoms after switching from methylphenidate: A case report

“…An up‐to‐date study suggested there were improvements in the SCT total and SCT‐Daydream scores both at home and at school after the use of methylphenidate, and SCT‐Sluggish scores were found to have improvements only at school (not at home). The study also claimed that the presence of SCT symptoms in children with ADHD had negative effects on methylphenidate treatment in the school area 27 . Another study pointed out that SCT‐sluggish/sleepy appearance symptoms did not respond to methylphenidate, whereas SCT‐daydreaming symptoms were not associated with methylphenidate nonresponse 7 .…”

A Preliminary Evaluation of the Utility of Sluggish Cognitive Tempo Symptoms in Predicting Behavioral Treatment Response in Children with Behavioral Difficulties

“…The current study represents a preliminary step in examining whether parentrated symptoms of sluggish cognitive tempo (SCT) have the potential to serve as a baseline predictor of behavioral treatment response in a sample of children receiving an eight week intensive behavioral intervention (i.e., the wellestablished Summer Treatment Program; STP). The emergence of substantial interest in SCT (Becker et al, 2016(Becker et al, , 2017Kofler et al, 2019) has given rise to a number of investigations examining the extent to which SCT symptoms respond to treatments for ADHD (Froehlich et al, 2018;Fırat et al, 2020) as well as whether children with greater levels of SCT symptoms respond similarly when compared to those with fewer symptoms of SCT. Given preliminary evidence of treatment response across some (Becker et al, 2014;Owens et al, 2016)-but not all (Pfiffner et al, 2007)-studies of children exhibiting SCT symptomology, we anticipated that SCT symptoms would be potentially useful in predicting behavioral treatment response in children with disruptive behavior problems.…”

“…However, these children appear to benefit the least from behavioral treatment with respect to social difficulties and internalizing problems suggesting that SCT symptoms may prove useful with respect to predicting treatment response across specific domains of functioning (Owens et al., 2016). Examinations of the potential impact of SCT symptomology in response to pharmacological treatment for ADHD has resulted in mixed findings as well (Firat et al., 2020; Froehlich et al., 2018; Ludwig et al., 2009; McBurnett et al., 2017).…”

Atomoxetine Might Be More Effective in Improving Sluggish Cognitive Tempo Symptoms Compared to Methylphenidate: A Case Report

“…An up-to-date study suggested there were improvements in the scores of SCT-Total and SCT-Daydreams both at home and at school after the use of methylphenidate, and SCT-Sluggish scores were found to have improvements only at school. The study also claimed that the presence of SCT symptoms in children with ADHD had negative effects on methylphenidate treatment in the school area (28). Another study points out that SCT-sluggish/sleepy appearance symptoms do not respond to methylphenidate, whereas SCT-daydreaming symptoms are not associated with methylphenidate nonresponse (7).…”