Efficacy and safety of methylphenidate on attention deficit hyperactivity disorder in children with Down syndrome

Roche, M; Mircher, Clotilde; Toulas, Jeanne; Prioux, E; Conte, Martine; Ravel, Aimé; Falquero, Ségolène; Labidi, A.; Stora, Samantha; Durand, Sophie; Mégarbané, André; Cieuta‐Walti, Cécile

doi:10.1111/jir.12832

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…Unfortunately, only 1 naturalistic study (n = 21) focusing on ADHD medication treatment (in this case, methylphenidate) in children with Down syndrome has been published to date. 2b This study by Roche et al, in which 48% of participants had treated congenital heart disorders, contributed the following observations: (1) The methylphenidate response rate of 76% was similar to that seen in typically developing children, (2) no serious adverse events were reported, and (3) similar to children without ID, the most commonly reported adverse events were sleep and appetite problems. Given the uncontrolled nature of the study, further study of methylphenidate effects in children with DS is certainly warranted, especially given that the limited studies of stimulant medication treatment in children with heterotypic ID have suggested that (1) rates of beneficial response may be less in children whose intelligence quotients are <50 compared with >50, and (2) there may be an increased risk of some adverse effects (e.g., social withdrawal) compared with typically developing populations.…”

Section: Tanya Froehlich MD Msmentioning

confidence: 81%

Complex Attention-Deficit/Hyperactivity Disorder in a Bilingual Child with Down Syndrome and Intellectual Disability

Moore,

Soccorso,

Fogler

et al. 2023

J Dev Behav Pediatr

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CASE: Maria is an 8-year-old girl with Down syndrome, described by her mother as an affectionate and social child, who was referred to developmental-behavioral pediatrics by her pediatrician because of increasing aggressive behaviors and inattention. Maria was 5 pounds at birth, delivered full-term by cesarean section, and hospitalized for 1 month after delivery because of feeding issues that required a nasogastric (NG) tube. Maternal age was 24 years, pregnancy was uncomplicated, and there were no reported prenatal exposures to substances. Additional medical history includes corrective cardiac surgery at age 11 months, mild-to-moderate hearing loss in 1 ear, and myopia. At the time of Maria's presentation to developmental-behavioral pediatrics, she was in third grade and had an IEP with placement in a substantially separate multigrade classroom and inclusion for special classes such as music and art. She had multiple academic goals and accommodations for behaviors such as eloping from class, shoving, and growling at adults; communication Picture Exchange Communication System (PECS); and extended time to complete assignments. Previously, she had attended an inclusion setting with a 1:1 aide. Maria is followed annually at a specialty clinic that focuses on the health needs of children with Down syndrome. At home, Maria's parents speak primarily Spanish, while her 2 older brothers speak primarily English. Maria has been using 3-word phrases since she was 6 years old and understands some American Sign Language. She also uses a PECS book for communication. During the visit, Maria was notably fidgety, frequently interrupted the parent interview despite having toys to play with, and became aggressive—hitting, kicking, pushing, and shoving—when she did not want to comply with directives. She used mostly single words and a variety of gestures to communicate. Both the parent-completed and teacher-completed Conners-3 (Long Version) produced elevated T-scores (>70) in the domains of inattention, hyperactivity/impulsivity, defiance/aggression, peer relations, Global Index scale, DSM-5 Hyperactive/Impulsive symptom scale, and DSM-5 Conduct Disorder symptom scale. The teacher endorsed full criteria for attention-deficit/hyperactivity disorder, consistent with combined presentation, and the parent endorsed symptoms in a similar pattern. Methylphenidate (2.5 mg) was trialed but tolerated poorly when it was titrated to 5 mg. Maria's mother reported that Maria's focus was somewhat better, but she was easily brought to tears and “not herself.” What would be the next steps in Maria's evaluation/treatment? Could there be reasons for her worsening behavior other than a primary attention disorder?

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Section: Tanya Froehlich MD Msmentioning

confidence: 81%

Complex Attention-Deficit/Hyperactivity Disorder in a Bilingual Child with Down Syndrome and Intellectual Disability

Moore,

Soccorso,

Fogler

et al. 2023

J Dev Behav Pediatr

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“…While most adverse effects occur in similar proportions as in the methylphenidate clinical trial results in the United States, the proportion of gastrointestinal and neurological problems was lower than that in clinical trials [ 42 ]. A previous survey also indicated that the adverse effects of methylphenidate were different from clinical trials [ 43 ]. This may indicate that results from self-reporting, such as surveys, differ from clinical trial results.…”

Section: Discussionmentioning

confidence: 99%

The Adverse Effects and Nonmedical Use of Methylphenidate Before and After the Outbreak of COVID-19: Machine Learning Analysis

Shin¹,

Yuniar²,

Kim³

2023

J Med Internet Res

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Background Methylphenidate is an effective first-line treatment for attention-deficit/hyperactivity disorder (ADHD). However, many adverse effects of methylphenidate have been recorded from randomized clinical trials and patient-reported outcomes, but it is difficult to determine abuse from them. In the context of COVID-19, it is important to determine how drug use evaluation, as well as misuse of drugs, have been affected by the pandemic. As people share their reasons for using medication, patient sentiments, and the effects of medicine on social networking services (SNSs), the application of machine learning and SNS data can be a method to overcome the limitations. Proper machine learning models could be evaluated to validate the effects of the COVID-19 pandemic on drug use. Objective To analyze the effect of the COVID-19 pandemic on the use of methylphenidate, this study analyzed the adverse effects and nonmedical use of methylphenidate and evaluated the change in frequency of nonmedical use based on SNS data before and after the outbreak of COVID-19. Moreover, the performance of 4 machine learning models for classifying methylphenidate use based on SNS data was compared. Methods In this cross-sectional study, SNS data on methylphenidate from Twitter, Facebook, and Instagram from January 2019 to December 2020 were collected. The frequency of adverse effects, nonmedical use, and drug use before and after the COVID-19 pandemic were compared and analyzed. Interrupted time series analysis about the frequency and trends of nonmedical use of methylphenidate was conducted for 24 months from January 2019 to December 2020. Using the labeled training data set and features, the following 4 machine learning models were built using the data, and their performance was evaluated using F-1 scores: naïve Bayes classifier, random forest, support vector machine, and long short-term memory. Results This study collected 146,352 data points and detected that 4.3% (6340/146,352) were firsthand experience data. Psychiatric problems (521/1683, 31%) had the highest frequency among the adverse effects. The highest frequency of nonmedical use was for studies or work (741/2016, 36.8%). While the frequency of nonmedical use before and after the outbreak of COVID-19 has been similar (odds ratio [OR] 1.02 95% CI 0.91-1.15), its trend has changed significantly due to the pandemic (95% CI 2.36-22.20). Among the machine learning models, RF had the highest performance of 0.75. Conclusions The trend of nonmedical use of methylphenidate has changed significantly due to the COVID-19 pandemic. Among the machine learning models using SNS data to analyze the adverse effects and nonmedical use of methylphenidate, the random forest model had the highest performance.

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“…Psychostimulants : Methylphenidate was studied in a small retrospective observational study in children with DS + ADHD and was found to be effective in 76% of cases. The most common side effects included loss of appetite and difficulty falling sleep, with 57% experiencing side effects, most which were not severe enough to interrupt treatment (Roche et al, 2021).…”

Section: Psychopharmacological Research Studies In Down Syndromementioning

confidence: 99%

Psychopharmacological treatments in Down syndrome and autism spectrum disorder: State of the research and practical considerations

Baumer,

Capone

2023

American J of Med Genetics Pt C

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Individuals with Down syndrome (DS) or Autism Spectrum Disorder (ASD), and especially those with both DS and co‐occurring ASD (DS + ASD) commonly display behavioral and psychiatric symptoms that can impact quality of life and places increased burden on caregivers. While the mainstay of treatment in DS and ASD is focused on educational and behavioral therapies, pharmacological treatments can be used to reduce symptom burden. There is a paucity of evidence and limited clinical trials in DS and DS + ASD. Some scientific evidence is available, primarily in open label studies and case series that can guide treatment choices. Additionally, clinical decisions are often extrapolated from evidence and experience from those with ASD, or intellectual disability in those without DS. This article reviews current research in pharmacological treatment in DS, ASD, and DS + ASD, reviews co‐occurring neurodevelopmental and mental health diagnoses in individuals with DS + ASD across the lifespan, and describes practical approaches to psychopharmacological management.

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Efficacy and safety of methylphenidate on attention deficit hyperactivity disorder in children with Down syndrome

Cited by 11 publications

References 19 publications

Complex Attention-Deficit/Hyperactivity Disorder in a Bilingual Child with Down Syndrome and Intellectual Disability

Complex Attention-Deficit/Hyperactivity Disorder in a Bilingual Child with Down Syndrome and Intellectual Disability

The Adverse Effects and Nonmedical Use of Methylphenidate Before and After the Outbreak of COVID-19: Machine Learning Analysis

Psychopharmacological treatments in Down syndrome and autism spectrum disorder: State of the research and practical considerations

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