Guidelines and algorithms for the use of methylphenidate in children with Attention-Deficit/Hyperactivity Disorder

Abstract

Objective: To review published algorithms for guiding the use of methylphenidate (MPH) in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. Methods: A consensus roundtable of 12 experts was convened to review the evidence for the safety and efficacy of MPH in the treatment of ADHD, as well as the published algorithms and practice guidelines for using MPH. The experts reviewed the algorithms for practicality and acceptability by clinicians. Results: Algorithms that included MPH commonly selected it as the initial medication to be employed in the treatment of children with ADHD. Factors involved included its high efficacy, good safety record, and the ubiquitous nature of its appearance in the ADHD treatment literature. Conclusions: MPH should be considered as the first medication to be used in a treatment algorithm for children and adolescents with ADHD.

Objective Versus Subjective Assessment of Methylphenidate Response

“…However, there is increasing recognition that this disorder is also prevalent among adults [1]. It is treated by means of pharmacotherapy and psychotherapy, with the pharmacotherapy consisting mainly of stimulants, and in particular methylphenidate (MPH) [2,3].…”

“…The response rate to MPH is approximately 85% [3,1]. In other words, 15% of the children receiving this treatment will not experience improvement.…”

Plasma level-dependent effects of methylphenidate on task-related functional magnetic resonance imaging signal changes

“…Methylphenidate (MPH) is a psychostimulant drug that is widely used to treat children and adults with attention deficit hyperactivity disorder (ADHD) and other neuropsychiatric disorders (Murray and Cassem 1998;Solanto 1998;Greenhill et al 2002;Biederman et al 2004;Leonard et al 2004). Mehta et al (2000) studied ten healthy male volunteers (mean age, 34.8 years) using PET in a placebo-controlled design.…”

Homer expression in the hippocampus of an animal model of attention-deficit/hyperactivity disorder

“…Stimulants were initially prescribed for ADHD in 1937, and MPH is currently one of the most commonly prescribed psychoactive stimulants for its treatment (44)(45)(46). MPH …”