Development of a Multimethod Clinical Protocol for Assessing Stimulant Drug Response in Children With Attention Deficit Disorder

Barkley, Russell A.; Fischer, Mariellen; Newby, Robert F.; Breen, Michael J.

doi:10.1207/s15374424jccp1701_3

Cited by 151 publications

(95 citation statements)

References 13 publications

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“…Unfortunately, the number of studies reporting on teacher-rated symptom improvements and math productivity as well as reading was insufficient for meta-regression. Further, most studies reporting on ontask behavior and academic performance measures indicate simultaneous improvements on both with improvements in on-task behavior ranging from 2.9 to 12.0% [20, 24, 32, [48][49][50][51][52][53][54][55]. Unfortunately, the number of studies in the current study was too small to test the mediating effects of on-task behavior using meta-regression.…”

Section: Discussionmentioning

confidence: 89%

Does methylphenidate improve academic performance? A systematic review and meta-analysis

Kortekaas-Rijlaarsdam

Luman

Sonuga‐Barke

et al. 2018

Eur Child Adolesc Psychiatry

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Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD. Previous reviews on stimulant-related academic improvements are inconclusive and focus on task engagement. Recent literature suggests outcome-domain-specific medication effects that are larger for productivity than for accuracy. The aims of this study are quantifying methylphenidate effects on academic productivity and accuracy for math, reading, spelling; exploring the mediating or moderating effects of symptom improvements, demographic-, design-and disorder-related variables. PubMed, EMBASE, ERIC and PsycINFO were searched for articles reporting methylphenidate effects on academic productivity and accuracy. Thirty-four studies met entry criteria. Methylphenidate improved math productivity (7.8% increase, p < .001); math accuracy (3.0% increase, p = .001); increased reading speed (SMD .47, p < .001) but not reading accuracy. None of the mediators or moderators tested affected methylphenidate efficacy. Academic improvements were small compared to symptom improvements; qualitative changes limited to math. Clinicians should take this discrepancy into account when prescribing medication for ADHD.

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Section: Discussionmentioning

confidence: 89%

Does methylphenidate improve academic performance? A systematic review and meta-analysis

Kortekaas-Rijlaarsdam

Luman

Sonuga‐Barke

et al. 2018

Eur Child Adolesc Psychiatry

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“…27 Less is known about the optimal dose of DEX, because there has been much less investigation into this drug than into MPH. The recommended dose of DEX is half that of MPH.…”

Section: Discussionmentioning

confidence: 99%

Methylphenidate Versus Dexamphetamine in Children With Attention Deficit Hyperactivity Disorder: A Double-blind, Crossover Trial

1997

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ABSTRACT. Objective. To compare methylphenidate (MPH) and dexamphetamine (DEX) in a sample of children with attention deficit hyperactivity disorder (ADHD).Method. A total of 125 children with ADHD received both MPH (0.3 mg/kg twice daily) and DEX (0.15 mg/kg twice daily) for 2 weeks a double-blind, crossover study. Outcome measures were Conners' Parent Rating ScaleRevised, Conners' Teacher Rating Scale-Revised, a Parent Global Perceptions questionnaire, the Continuous Performance Test, and the Barkley Side Effects Rating Scale.Results. There were significant group mean improvements from baseline score on all measures for both stimulants. On the Conners' Teacher Rating Scale-Revised, response was greater on MPH than DEX on the conduct problems and hyperactivity factors, as well as on the hyperactivity index. On the Conners' Parent Rating Scale-Revised, anxiety was the only factor to differ significantly, in favor of MPH. Parents rated 73% of subjects as globally improved on MPH and 69% improved on DEX, compared with baseline. Overall, 46% of parents chose MPH as the preferred drug, compared with 37% who chose DEX. On the Continuous Performance Test, there was no difference in the number of correct responses or errors between the two drugs.Conclusions. Most children with ADHD improve significantly on both MPH and DEX. There was a slight advantage to MPH on most measures. Pediatrics 1997;100(6). URL: http://www.pediatrics.org/cgi/ content/full/100/6/e6; attention deficit hyperactivity disorder, stimulant medication, methylphenidate, dexamphetamine.ABBREVIATIONS. ADHD, attention deficit hyperactivity disorder; MPH, methylphenidate; DEX, dexamphetamine; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th ed; CBCL, Child Behavior Checklist; TRF, Teacher Report Form; CPRS-R, Conners' Parent Rating Scale-Revised; CTRS-R, Conners' Teacher Rating Scale-Revised; CPT, Continuous Performance Test; SERS, side effect rating scale. S timulant medication is the most effective treatment for children with attention deficit hyperactivity disorder (ADHD).1,2 Stimulants have been shown to induce short-term enhancement of behavioral, academic, and social functioning. Many well-designed, placebo-controlled studies have demonstrated beyond doubt the benefits of stimulants in the vast majority of children with ADHD.2-4 In a review of 110 studies on the effects of stimulant drugs on more than 4200 children with ADHD, Barkley 4 found that ϳ75% of subjects were regarded as improved on stimulants. The mean placebo response was 39%.Methylphenidate (MPH) and dexamphetamine (DEX) are the two stimulants prescribed most frequently and have been shown to have similar types of positive effects in children with ADHD. However, it is not known whether one is more efficacious than the other in terms of probability of producing a positive response, magnitude of response, quality of improved performance, or side-effect profile. Some authors suggest that the two stimulants are equally effective 5 or that "there is little to choose between ...

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“…Capsules of medication and placebo were made and dispensed as described by Barkley (1988). After their initial assessment, children were randomly assigned to one of six possible sequences of the placebo (P), low-dose (L), and highdose conditions (H) by the clinical pharmacist: PLH, PHL, LHP, LPH, HPL, and HLP.…”

Section: Methodsmentioning

confidence: 99%

Children with ADHD and motor dysfunction compared with children with ADHD only

Tervo¹,

Azuma²,

Fogas³

et al. 2002

Develop Med Child Neuro

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The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixtythree children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.05 mg/kg, twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.

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Development of a Multimethod Clinical Protocol for Assessing Stimulant Drug Response in Children With Attention Deficit Disorder

Cited by 151 publications

References 13 publications

Does methylphenidate improve academic performance? A systematic review and meta-analysis

Does methylphenidate improve academic performance? A systematic review and meta-analysis

Methylphenidate Versus Dexamphetamine in Children With Attention Deficit Hyperactivity Disorder: A Double-blind, Crossover Trial

Children with ADHD and motor dysfunction compared with children with ADHD only

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