Buspirone versus methylphenidate in the treatment of children with attention- deficit/ hyperactivity disorder:
Mohammad-Reza Mohammadi1, Poopak Hafezi, Ali Galeiha
1Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
This study compared buspirone and methylphenidate for treating attention-deficit/hyperactivity disorder (ADHD) in children. Methylphenidate demonstrated greater efficacy than buspirone in reducing ADHD symptoms.
Area of Science:
- Pediatric neurology
- Child and adolescent psychiatry
- Pharmacology
Background:
- Conflicting evidence exists regarding buspirone's efficacy for attention-deficit/hyperactivity disorder (ADHD) in children.
- Previous trials yielded inconsistent results, necessitating further investigation into its therapeutic potential.
Purpose of the Study:
- To compare the efficacy of buspirone versus methylphenidate in treating ADHD in children.
- To evaluate treatment outcomes using standardized parent and teacher rating scales.
Main Methods:
- A 6-week, double-blind, randomized clinical trial involving 40 outpatients diagnosed with ADHD.
- Participants were randomized to receive either buspirone (20-30 mg/day) or methylphenidate (20-30 mg/day) based on weight.
- Outcomes were assessed using the Teacher and Parent ADHD Rating Scale IV at baseline, day 21, and day 42.
Main Results:
- Both treatments showed improvement in ADHD symptoms from baseline.
- Methylphenidate group exhibited significantly greater reductions in scores on both Parent and Teacher ADHD Rating Scales compared to the buspirone group.
- Side effects were comparable, with decreased appetite, headache, and insomnia noted more in the methylphenidate group.
Conclusions:
- Buspirone was found to be less effective than methylphenidate for treating ADHD in children in this trial.
- Methylphenidate remains a more effective therapeutic option for pediatric ADHD based on these findings.
Abstract:
A recent randomized clinical trial showed buspirone efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double blind randomized clinical trial. Forty outpatients with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of buspirone at a dose of 20-30 mg/day depending on weight (20 mg/day for < 30kg and 30 mg/day for > 30kg) (group 1) or methylphenidate at a dose of 20-30 mg/day depending on weight (20 mg/day for < 30kg and 30 mg/day for > 30kg (group 2) for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -8.95±8.73 (mean±SD) and -15.60±7.81 (mean±SD) for buspirone and methyphenidate, for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -9.80 ±7.06 (mean±SD) and -22.40±9.90 (mean±SD) for buspirone and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the buspirone and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of buspirone was less effective than methylphenidate in the treatment of ADHD.
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