Medication compliance in hyperactive children

Medication compliance was studied over an 18-week period in 12 male children, ages 6 to 12 years, who were receiving medication for "hyperactivity." Subjects were randomly assigned to receive placebo (PB), d-amphetamine (AMP), and methylphenidate (MPH) for 6 weeks each in a triple-blind, crossover design. Urine samples were obtained weekly and assayed for MPH and AMP to assess compliance. Individual patient compliance varied from 0.00% to 100% (x = 67%) while taking MPH and from 20% to 83% (x = 60%) while taking AMP. The percent of patients compliant for a given week varied from 55% to 80% (x = 67%) when taking MPH and from 25% to 83% (x = 61%) when taking AMP. Significant positive noncompliance also occurred; ie, MPH was found in urine during the PB period in five of 12 individuals. Poor compliance in taking medication may explain, in part, the variable and conflicting results reported in many studies of the effect of medication on improving the behavior of hyperactive children.