Related Experiment Videos
Efficacy of methylphenidate for attention-deficit hyperactivity disorder in children with tic disorder
K D Gadow1, J Sverd, J Sprafkin
1Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, USA.
Insights
Methylphenidate effectively treats attention-deficit hyperactivity disorder (ADHD) in children with tic disorders. This study found it safe and effective, with no significant worsening of tics observed.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Pharmacology
Background:
- Previous interpretations suggested stimulants were ill-advised for ADHD in children with tic disorders.
- Case reports and surveys raised concerns about stimulant use in this population.
Purpose of the Study:
- To investigate the safety and efficacy of methylphenidate for treating ADHD in children with comorbid tic disorder.
- To assess the impact of methylphenidate on both ADHD symptoms and tic severity.
Main Methods:
- Double-blind, placebo-controlled study involving 34 prepubertal children with ADHD and tic disorder.
- Administration of methylphenidate hydrochloride at three dosages (0.1, 0.3, 0.5 mg/kg) twice daily for 2 weeks.
- Assessment via direct behavioral observations in a simulated classroom and parent, teacher, and physician rating scales.
Main Results:
- Methylphenidate demonstrated significant suppression of hyperactive, disruptive, and aggressive behaviors.
- No significant alteration in the overall severity of tic disorder was observed.
- A potential weak effect on tic frequency was noted: motor tics increased, while vocal tics decreased.
Conclusions:
- Methylphenidate is a safe and effective treatment option for the majority of children with ADHD and comorbid tic disorder.
- The findings challenge previous interpretations regarding the contraindication of stimulants in this patient group.
Background:
The findings from case reports and patient questionnaire surveys have been interpreted as indicating that administration of stimulants is ill-advised for the treatment of attention-deficit hyperactivity disorder in children with tic disorder.
Methods:
Thirty-four prepubertal children with attention-deficit hyperactivity disorder and tic disorder received placebo and three dosages of methylphenidate hydrochloride (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks each, under double-blind conditions. Treatment effects were assessed using direct observations of child behavior in a simulated (clinic-based) classroom and using rating scales completed by the parents, teachers, and physician.
Results:
Methylphenidate effectively suppressed hyperactive, disruptive, and aggressive behavior. There was no evidence that methylphenidate altered the severity of tic disorder, but it may have a weak effect on the frequency of motor (increase) and vocal (decrease) tics.
Conclusion:
Methylphenidate appears to be a safe and effective treatment for attention-deficit hyperactivity disorder in the majority of children with comorbid tic disorder.