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Differential effects of methylphenidate and dextroamphetamine on the motor activity level of hyperactive children
B G Borcherding1, C S Keysor, T B Cooper
1Child Psychiatry Branch, NIMH, Bethesda, MD 20892.
Insights
Methylphenidate and dextroamphetamine reduce hyperactivity in boys. Methylphenidate showed greater effectiveness in reducing motor activity compared to dextroamphetamine and placebo.
Area of Science:
- Pediatric Neurology
- Psychopharmacology
- Child Psychology
Background:
- Hyperactivity in children is a significant concern impacting academic and social functioning.
- Pharmacological interventions are commonly used to manage symptoms of hyperactivity.
Purpose of the Study:
- To compare the effectiveness of methylphenidate and dextroamphetamine in reducing motor activity in hyperactive boys.
- To assess the dose-response relationship and plasma concentration correlation with motor activity reduction.
Main Methods:
- An 11-week double-blind crossover trial involving 18 hyperactive boys.
- Continuous measurement of motor activity using an acceleration-sensitive device.
- Administration of methylphenidate, dextroamphetamine, or placebo twice daily.
Main Results:
- Methylphenidate significantly reduced motor activity in both structured and less structured settings.
- Dextroamphetamine's effects were similar but did not significantly differ from placebo during specific classroom times.
- Methylphenidate demonstrated a greater reduction in motor activity than dextroamphetamine between 11:00 AM and 1:00 PM.
- No significant differences in activity levels were observed between different drug doses within each phase.
- Plasma drug concentrations did not correlate with observed decrements in motor activity.
Conclusions:
- Methylphenidate appears to be more effective than dextroamphetamine in reducing motor activity in hyperactive boys.
- The study highlights differential drug effects on motor activity, suggesting tailored treatment approaches.
- Further research is needed to explore optimal dosing and individual responses.
Abstract:
An acceleration-sensitive device was used to measure motor activity continuously through the day in 18 hyperactive boys in a day hospital program. The children received methylphenidate, dextroamphetamine, or placebo daily after breakfast and lunch in an 11-week double-blind crossover trial. Differential effectiveness of the two drugs in lowering motor activity was found. Methylphenidate significantly lowered activity measurements in a morning structured classroom and in less structured activities in the afternoon. Dextroamphetamine effects on activity were similar, although they did not differ significantly from placebo effects between 11:00 AM and noon in our classroom setting. Methylphenidate produced a greater decrement in motor activity than did dextroamphetamine between 11:00 AM and 1:00 PM. There were no significant differences in activity level between drug doses within each drug phase across the dose ranges used (for methylphenidate 0.45 to 1.25 mg/kg given twice daily, and for dextroamphetamine 0.2 to 0.6 mg/kg given twice daily). Plasma drug concentrations did not correlate with decrements in activity for either drug.