Methylphenidate (Ritalin) is widely prescribed for hyperkinetic children. This study showed a peak enchancement of learning in children after being given a dose of 0.3 milligram per kilogram of body weight, and a decrement in learning in those given larger doses; social behavior showed the most improvement in children given 1.0 milligram per kilogram. These results had been hypothesized from theoretical dose-response curves which indicate different target behaviors would improve at different doses.
Their classroom teachers rated 291 schoolchildren, grades kindergarten through 6, on Conners' Teacher Rating Scale, developed for and used widely in drug studies in children. Scores were found to be significantly lower than those reported for a similar group of 92 New York children and considerably less than those of a group of 64 children receiving medication for deviant behavior. Boys generally had higher scores for acting-out-type behavior while girls scored higher on neuroticism. The factor structure in this sample showed some differences from that in Conners' original analysis but they are insufficient for any change in the widely accepted scoring system, except perhaps to add a fifth factor of sociability.
A clinical trial in two groups of hyperactive/ aggressive children showed that methylphenidate was superior to placebo for about 2/3 of the children, but that there was little difference in effectiveness between different dosage levels, especially once 0.3 mg/kg is attained. Mild side effects were common at higher dosages. Of a variety of physician, parent, teacher and psychological test and behavioral measures, teacher and physician ratings were the most sensitive to drug effects. No measures including neurological ones discriminated between responders and non-responders. It is concluded that methylphenidate is a useful treatment for hyperactive/aggressive children but that current doses may be too high and side effects more common than stated.
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