Randomized controlled double‐blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability

Simonoff, Emily; Taylor, Eric; Baird, Gillian; Bernard, Sarah; Chadwick, Oliver; Liang, Holan; Whitwell, Susannah; Riemer, Kirsten; Sharma, Kishan; Sharma, Santvana Pandey; Wood, Natalie J.; Kelly, Joanna; Golaszewski, Ania; Kennedy, Juliet; Rodney, Lydia; West, Nicole; Walwyn, Rebecca; Jichi, Fatima

doi:10.1111/j.1469-7610.2012.02569.x

Cited by 101 publications

(68 citation statements)

References 25 publications

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“…For example, work from the National Survey of Children’s Health found that approximately 20% of nearly 1,500 children aged 2–17 with parent-reported ASD were initially given a diagnosis of ADHD, and were diagnosed with ASD three years later than children without ADHD concerns (Miodovnik et al 2015). Studies also indicate differences in response to treatments based on presence/absence of ADHD symptoms in children with ASD (Antshel et al 2011; Cortese et al 2012; Pearson et al 2012; Simonoff et al 2013). Finally, concerns about attention problems, in both those with ASD and their siblings, that persist into middle childhood and school settings also underscore the importance of developing a better understanding of how the two disorders manifest alone and together in childhood (Miller et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

Lyall

Schweitzer

Schmidt

et al. 2017

Research in Autism Spectrum Disorders

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Background Attention deficits in young children with autism spectrum disorder (ASD) are not well understood. This study sought to determine: 1) the prevalence of ADHD symptoms in young children with ASD, typical development (TD), and developmental delay (DD) and 2) the association between ADHD symptoms and cognitive and behavioral functioning in children with ASD. Method ADHD symptoms, defined according to Aberrant Behavior Checklist (ABC) hyperactivity subscale scores, were compared across children aged 2–5 from a large case-control study with ASD (n=548), TD (n=423), and DD (n=180). Inattention and hyperactivity items within this subscale were also explored. Within the ASD group, linear and logistic regression were used to examine how ADHD symptoms were associated with cognition as assessed by the Mullen Scales of Early Learning and adaptive functioning as assessed by the Vineland Adaptive Behavior Scales. Results Mean hyperactivity subscale scores were lowest in children with TD (mean=3.19), higher in children with DD (12.3), and highest in children with ASD (18.2; between-group p<0.001). Among children with ASD, significant associations were observed with higher ADHD symptoms and poorer adaptive and cognitive functioning (adjusted beta for hyperactivity score in association with: Vineland composite = −5.63, p=0.0005; Mullen visual reception scale = −2.94, p=0.02; for the highest vs. lowest quartile of hyperactivity score, odds of lowest quintile of these scores was approximately doubled). Exploratory analyses highlighted associations with inattention-related items specifically. Conclusion These results suggest ADHD symptoms may play a key role in the functioning of young children with ASD.

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Section: Introductionmentioning

confidence: 99%

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

Lyall

Schweitzer

Schmidt

et al. 2017

Research in Autism Spectrum Disorders

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“…Dose titration in the MPH treatment is recommended for optimal response and minimum adverse effects. 6 However, there are limited studies investigating the relationship between OROS-MPH doses and plasma MPH concentrations in children and adolescents. A small study (n = 17) reported that high-dose OROS-MPH, used with other medications, was not associated with unusually elevated plasma MPH concentrations.…”

Section: Introductionmentioning

confidence: 99%

Plasma Methylphenidate Levels in Youths With Attention Deficit Hyperactivity Disorder Treated With OROS Formulation

Yorbık

Mutlu

Ozilhan

et al. 2015

Therapeutic Drug Monitoring

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Our findings point to the fact that plasma levels of MPH show a wide range of changes at similar doses, correlate positively with the doses and, as expected, are not affected by using risperidone, sertraline, fluoxetine, and aripiprazole. Therapeutic drug monitoring may help to optimize MPH dose in patients not responding to treatment or in those experiencing serious side effects, but not in routine clinical practice. The presence of intermediate dose formulations such as 45-mg tablets for OROS-MPH may contribute to the optimization.

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“…However, some studies have shown severe adverse effects with methylphenidate including social withdrawal, irritability, insomnia, and anorexia in children with ASD [34].…”

Section: Stimulants and Non-stimulantsmentioning

confidence: 99%

Pharmacobiological Treatments in Autism Spectrum Disorders

Jayaraman¹,

Mundkur²

2017

IJCRR

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Autism spectrum disorders (ASD) refer to a group of neuro-developmental disorders affecting young children and adults. Currently, the treatment options for ASD are mostly restricted to treating its symptoms. Among the various approaches for treating ASD, pharmacobiology-based treatments are numerous. Our objective is to review the up-to-date information on different types of medications and briefly discuss the evidence-based potential of these treatments in ASD therapy. PubMed searches for reports and reviews on clinical data from the last 15 years, between 2002-2017, using search terms of each category of treatment along with the terms "autism", "mechanism", and/or "side effects" were conducted. Several pharmacobiological interventions have been prescribed for ASD, including antipsychotics, stimulants, antidepressants, supplements, and special diets. However, none of these methods is an effective ASD treatment, and only few show much promise. We provide a brief overview of the current pharmacobiological treatments for ASD, their mechanisms of action, and clinical research-based evidence on their effectiveness. Based on our review, we recommend that caution should be exercised when choosing a pharmacobiological treatment method for ASD as majority of existing evidence is not from large-scale long-term high quality studies.Future research should focus on rigorous investigative design, long-term implementation, and meaningful uniform outcome measurements.

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Randomized controlled double‐blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability

Abstract: Optimal dosing of methylphenidate is practical and effective in some children with hyperkinetic disorder and intellectual disability. Adverse effects typical of methylphenidate were seen and medication use may require close monitoring in this vulnerable group.

Cited by 101 publications

References 25 publications

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study

Plasma Methylphenidate Levels in Youths With Attention Deficit Hyperactivity Disorder Treated With OROS Formulation

Pharmacobiological Treatments in Autism Spectrum Disorders

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