Methylphendate and Adhd: Influence of Age, Iq and Neurodevelopmental Status

Abstract

SUMMARY Sixty‐nine children with attention deficit hyperactivity disorder (ADHD) underwent blind methyl‐phenidate trials. 36 had ADHD alone (with or without a learning disability) and 33 had additional neurodevelopmental disorders. Of the children with ADHD alone, 88 per cent improved significantly on methylphenidate. This did not differ significantly from the 69 per cent response rate for children with ADHD and other neurodevelopmental disorders. The results confirm and add to the research literature indicating that ADHD children who are of preschool age and/or who have co‐existing neurological disorders may benefit from methylphenidate. RÉSUMÉ Methylphénidate et ADHD: Influence de l'âge, du QI et de l'état neurodévelopmental Des essais aveugles de traitement par méthylphénidate ont été entrepris chez 69 enfants presentant un trouble de déficit d'attention et hyperactivity (ADHD). Dans 36 cas l'ADHD était isote avec ou sans trouble des apprentissages et dans les 33 cas restant, il y avait en plus des troubles neurodévelopmentaux (ND). Parmi les enfants avec ADHD isolé, 88 pour cent furent améliorés significativement par le méthylphénidate. Ceci ne différait pas significativement du 69 pour cent taux de réponses chez les enfants avec ADHD etc d'autres troubles ND. Ces résultats confirment et s'ajouterit aux données de la littérature indiquant que les enfants ADHD d'âge préscolaire avec ou sans trouble neurologique coexistant peuvent bénéficicr du méthylphénidate. ZUSAMMENFASSUNG Methylphenidat und ADHD: Einfluß von Alter, IQ und entwicklungsneurologischem Befund Bei 69 Kindern mit Aufmerksamkeitsstörungen und Hyperaktivität (ADHD) wurden blinde Behandlungsversuche mit Methylphenidat durchgeführt. 36 Kindern hatten nur eine ADHD (mit Oder ohne Lernschwäche) und 33 hatten zusätzlich entwicklungsneurologische (ND) Störungen. Von den Kindern mit ADHD allein zeigten 88 Prozent eine signifikante Besserung auf Methylphenidat. Es bestand kein signifikanter Unterschied zur 69 Prozent Ansprechrate der Kinder mit ADHD und andercn ND Störungen. Die Ergebnisse bestätigen und ergänzen die wissenschaftliche Literatur dahingehend, daß Vorschulkinder mit ADHD und/oder mit gleichzeitig bestehenden neurologischen Erkrankungen von der Behandlung mit Methylphenidat profitieren. RESUMEN Metilfenidato y ADHD: influencia de la edad, CI y estatus neuroevolutivo Sesenta y nueve niños con alteración de la atencion e hiperactividad (AAH, ADHD en inglés) fueron sometidos a una prueba con metilfenidato ciega. 36 tenian solo AAH (con o sin dificultad para el aprendizaje) y 33 tenian además alteraciones del desarrollo (AD). De los niños con AAH solo, 88 por ciento mejoraron significativamente con el metilfenidato. Esta respuesta no diferia significativamente del promedio de respuesta 69 por ciento en niños con AAH y otra alteracion del desarrollo (AD). Los resultados confirman y coadyuvan a la literatura indicando que los niños, con AAH en edad preescolar y/o una alteración neurológica coexistente pueden beneficiarse del metilfenidato.

Psychopharmacological and Other Treatments in Preschool Children with Attention-Deficit/Hyperactivity Disorder: Current Evidence and Practice

“…Data on side effect profile in preschool children was also divergent. Rates of side effects ranged from minimal or clinically negligible (Conners 1975) to 89% in typically developing preschool children (Schleifer et al 1975) and 45%-50% in preschool children with developmental disorders (Handen et al 1999;Mayes et al 1994). Dysphoria, crying, whining, irritability, and solitary play were more frequently reported in preschool children than seen in older children.…”

“…Of the other two studies, one included a mixture of inpatient or outpatient preschool and school age children with ADHD who were either typically developing or had autism or other developmental disorders (Mayes et al 1994), and the one remaining blinded study treated preschool children with developmental disorders (Handen et al 1999). The diagnostic procedure used most frequently included a combination of clinical interview and dimensional rating scales.…”

A Pilot Study of Atomoxetine in Young Children with Attention-Deficit/Hyperactivity Disorder

“…Unfortunately, until recently, only 10 of over 160 controlled trials of psychostimulants for school-aged children included preschoolers ages 4-6, and all 10 assessed the use of methylphenidate (MPH) (Conners 1975;Schleifer et al 1975;Cohen et al 1981;Barkley et al 1984;Barkley 1988;Mayes et al 1994;Musten et al 1997;Firestone et al 1998;Handen et al 1999;Chacko et al 2005). Even in these few trials, not all of the samples were made up entirely of young children.…”

Treatment strategies for ADHD in preschool and school-age children

“…26,27 The general consensus is that psychostimulants are relatively safe and generally well tolerated as ADHD treatment for preschoolers. [24][25][26][28][29][30][31][32][33][34][35] Treatment of ADHD in school-age children (ages 6 to 12 years) follows the accepted gold standard treatment with psychostimulant medications such as methylphenidate. The Multimodal Treatment Study of Children with ADHD is respected by many in the area of child psychiatry as current best evident treatment for school-age children with ADHD.…”