Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study. Positive Effects of Methylphenidate on Inattention and Hyperactivity in Pervasive Developmental Disorders: An Analysis of Secondary Measures Five-fold increase in national prevalence rates of attention-deficit/hyperactivity disorder medications for children and adolescents with autism spectrum disorder, attention-deficit/hyperactivity disorder, and other psychiatric disorders: a Danish register-based study. Depression, anxiety and obsessive-compulsive symptoms and quality of life in children with attention-deficit hyperactivity disorder (ADHD) during three-month methylphenidate treatment Long-acting methylphenidate has an effect on aggressive behavior in children with attention-deficit/hyperactivity disorder. Effect of vitamin D treatment in children with attention-deficit hyperactivity disorder Sex Differences in Effectiveness of Extended-Release Stimulant Medication among Adolescents with Attention-Deficit/Hyperactivity Disorder [The prevalence of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in Germany. Initial results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Effects of Methylphenidate on Impulsive Responding in Children With Attention-Deficit Hyperactivity Disorder Controlled-release methylphenidate improves attention during on-road driving by adolescents with attention-deficit/hyperactivity disorder. Behavioral Effects of Neurofeedback Compared to Stimulants and Physical Activity in Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial. Clinical evaluation of subjective and objective changes in motor activity and attention in children with attention-deficit/hyperactivity disorder in a double-blind methylphenidate trial. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months Efficacy of Methylphenidate Among Children with Autism and Symptoms of Attention-Deficit Hyperactivity Disorder Treatment of attention deficit hyperactivity disorder in children Buspirone Versus Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder: A Double-Blind and Randomized Trial The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder. Combined ω3 and ω6 Supplementation in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Refractory to Methylphenidate Treatment Effects and noneffects of methylphenidate in children with mental retardation and ADHD. Effects of OROS Methylphenidate on Academic, Behavioral, and Cognitive Tasks in Children 9 to 12 Years of Age With Attention-Deficit/Hyperactivity Disorder Atomoxetine, Parent Training, and Their Combination in Children With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Treatment of ADHD in children with tics: A randomized controlled trial
BACKGROUND In the recent past , psychiatrists and paediatricians have avoided prescribing stimulant medication , such as methylpheni date and dexamphetamine to patients with autism spectrum disorders ( ASD ) because of both doubts about efficacy and concern that these medications make stereotypies worse . Recently , a number of small trials have suggested that methypheni date does have a role in the management of hyperactivity in children with autistic spectrum disorders . METHODS Children with ASD and attention deficit hyperactivity disorder ( ADHD ) , and children with ADHD without ASD received st and ard treatment with methypheni date from one specialist centre . A combination of st and ardized and novel outcome tools was used to allow both an exploratory retrospective study of 174 children and then a prospect i ve study of a further 52 children to be carried out . RESULTS After treatment with stimulants , the subjects in both groups showed statistically significant improvements in target symptoms of ' hyperactivity ' , ' impulsivity ' , ' inattention ' , ' oppositionality ' , ' aggression ' and ' intermittent explosive rage ' . The Clinical Global Impression-Improvement and efficacy index measures also improved in each group . In both the retrospective and the prospect i ve studies , there was no statistically significant difference in the degree of improvements between each group . Importantly , neither tics nor repetitive behaviours worsened in either group . Children in the ' ADHD-only ' group who were prescribed stimulants experienced significant ' nausea ' , ' giddiness ' , ' headaches ' and ' sleep difficulties ' , whereas sleep difficulties were the only side effect that emerged in children in the ASD with ADHD group . CONCLUSIONS Both studies presented here support previous findings from smaller studies that show children with autism and ADHD can respond as well to stimulants as children with ADHD alone . Although r and omized controlled trials remain the gold st and ard for efficacy studies , systems like this that allow clinicians to continue rigorous and consistent monitoring for many years have a valuable role to play . Furthermore , such monitoring systems which now exist electronically can easily accumulate large data sets and reveal details about long-term effectiveness and long-term side effects of medication that are unlikely to be discovered in short-term trials BACKGROUND Methylpheni date has been shown elsewhere to improve hyperactivity in about half of treated children who have pervasive developmental disorders ( PDD ) and significant hyperactive-inattentive symptoms . We present secondary analyses to better define the scope of effects of methylpheni date on symptoms that define attention-deficit/hyperactivity disorder ( ADHD ) and oppositional defiant disorder ( ODD ) , as well as the core autistic symptom domain of repetitive behavior . METHODS Sixty-six children ( mean age 7.5 y ) with autistic disorder , Asperger 's disorder , and PDD not otherwise specified , were r and omized to varying sequences of placebo and three different doses of methylpheni date during a 4-week blinded , crossover study . Methylpheni date doses used approximated .125 , .25 , and .5 mg/kg per dose , twice daily , with an additional half-dose in the late afternoon . Outcome measures included the Swanson , Nolan , and Pelham Question naire revised for DSM-IV ( ADHD and ODD scales ) and the Children 's Yale-Brown Obsessive Compulsive Scales for PDD . RESULTS Methylpheni date was associated with significant improvement that was most evident at the .25- and .5-mg/kg doses . Hyperactivity and impulsivity improved more than inattention . There were not significant effects on ODD or stereotyped and repetitive behavior . CONCLUSIONS Convergent evidence from different assessment s and raters confirms methylpheni date 's efficacy in relieving ADHD symptoms in some children with PDD . Optimal dose analyses suggested significant interindividual variability in dose response OBJECTIVE The purpose of this study was to estimate the prevalence and time trends in prescriptions of methylpheni date , dexamphetamine , and atomoxetine in children and adolescents , within three diagnostic groups : 1 ) autism spectrum disorder ( ASD ) , 2 ) attention-deficit/hyperactivity disorder ( ADHD ) , and 3 ) other psychiatric disorders . METHODS Data from six different national registers were used and merged to identify a cohort of all children and adolescents born in Denmark between 1990 and 2001 ( n=852,711 ) . Sociodemographic covariates on cohort members and their parents and lifetime prescriptions of methylpheni date , dexamphetamine , and atomoxetine were extracted from the registers . Prescriptions were also stratified by duration ( < 6 months . vs.≥ 6 months ) . RESULTS Sixteen percent of 9698 children and adolescents with ASD ( n=1577 ) , 61 % of 11,553 children and adolescents with ADHD ( n=7021 ) and 3 % of 48,468 children and adolescents with other psychiatric disorders ( n=1537 ) were treated with one or more ADHD medications . There was a significant increase in prescription rates of these medications for all three groups . From 2003 to 2010 , youth 6 - 13 years of age with ASD , ADHD , and other psychiatric disorders had 4.7-fold ( 4.4 - 4.9 ) , 6.3-fold ( 6.0 - 6.4 ) , and 5.5-fold ( 5.0 - 5.9 ) increases , respectively , in prescription rates of ADHD medications . CONCLUSION This is the largest study to date assessing stimulant treatment in children and adolescents with ASD , and is the first prospect i ve study quantifying the change over time in the prevalence of treatment with ADHD medications in a population -based national cohort of children and adolescents with ASD . The prevalence of stimulant treatment in youth with ASD of 16 % is consistent with earlier studies . The past decade has witnessed a clear and progressive increase in the prescription rates of medications typically used to treat ADHD in children and adolescents in Denmark . This increase is not limited to only those with ADHD , but includes others with neuropsychiatric disorders , including ASD . The risks and benefits of this practice await further study The current study was design ed to investigate the changes that occur in depression , anxiety , obsessive — compulsive symptoms and health-related quality of life during methylpheni date ( MPH ) treatment in children with attention-deficit hyperactivity disorder ( ADHD ) . Forty-five treatment naive children with ADHD , aged 8—14 , were assessed based on self , parent and teacher reports at the baseline and at the end of the first and third month of MPH treatment regarding changes in inattention , hyperactivity , impulsivity , depression , anxiety and obsessive — compulsive symptoms . Changes in the quality of life were also noted . Repeated measures of analysis of variance ( ANOVA ) tests with Bonferroni corrections were conducted in order to evaluate the data . Symptoms of inattention , hyperactivity and impulsivity were significantly reduced ( p < 0.017 ) following a three-month MPH treatment . There were significant decreases in depression ( p = 0.004 ) , trait anxiety ( p = 0.000 ) and checking compulsion symptom scores ( p = 0.001 ) . Moreover , parents reported significant improvements in psychosocial ( p = 0.001 ) and total scores ( p = 0.009 ) of quality of life , despite no change in physical health scores ( p > 0.05 ) . Children ’s ratings of quality of life measures showed no significant changes in physical health and psychosocial scores ( p > 0.05 ) , while total scores significantly improved ( p = 0.001 ) after the treatment . Over a three-month MPH treatment , depression , trait anxiety and checking compulsion symptoms decreased and quality of life seemed to improve along with those of inattention , hyperactivity and impulsivity INTRODUCTION Aggression is frequently observed in children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) . The aim of this study was to assess the efficacy with regard to oppositional and aggressive behavior of a new long-acting methylpheni date preparation ( Medikinet retard , MPH-MR ) , with equal portions of the immediate-release and the sustained-release active substance , and especially to look at correlations between either teacher or parent assessment of aggression and ADHD sub-symptomatology . METHODS Eighty five children and adolescents ( 6 - 16 years ) were investigated in a double-blind , r and omized , clinical trial over 5 weeks under a treatment with MPH-MR  using symptom checklists for ADHD , oppositional-defiant and conduct disorder according to the Diagnostic and Statistical Manual of Mental Disorders , 4th edition ( DSM-IV ) . RESULTS A total of 64.9 % of the children showed oppositional defiant disorder/conduct disorder ( ODD/CD ) symptoms . A statistically significant effect was found in the group treated with MPH ( verum-group ) . On the basis of Cohen 's criteria , high effects were found for aggressive symptoms in school ( d = 1.0 ) , but not in the afternoon ( d = 0.4 ) . There were also lower effect sizes for more severe aggressive symptoms . We found characteristic correlations between ODD/CD symptoms and the ADHD subscale hyperactivity/impulsivity compared to the subscale inattention . CONCLUSIONS Long-acting MPH is effective in the treatment of oppositional-defiant and aggressive behavior , especially concerning milder symptoms . The expected correlation between impulsivity and aggressiveness could be confirmed Background In this research the symptom improvement of attention-deficit hyperactivity disorder ( ADHD ) of children was assessed by oral vitamin D administration  in Tabriz , Iran . Methods In this double-blind , r and omized clinical trials , 96 children ( 2–18 years ) were enrolled to placebo and vitamin D groups . Children took vitamin D pearl ( 50,000 IU/week ) or placebo for 6 weeks . Children , who had the change in methylpheni date dosage and received any anticonvulsants and corticosteroids were excluded from the research . ADHD symptoms were diagnosed by Conners parent rating scale ( CPRS ) test at baseline and after intervention . ADHD Conners divided into inattention ( IA ) , hyperactivity/impulsivity ( H/I ) and combination type ( C ) subscales .  Vitamin D serum level was assessed at baseline and after 8 weeks in both groups . Results The differences between CPRS and its subscales were not significant at baseline ( P > 0.05 ) . The Conners IA score was decreased in vitamin D group ( P < 0.05 ; adjusted with age and baseline values ) . ADHD Conners and all subscale scores reduced remarkably after intervention in patients with insufficient level of vitamin D compared to placebo ( P < 0.05 ) . Conclusions Oral vitamin D  improved ADHD symptoms with a particular effect on inattention symptoms . In addition , symptoms related to all subscales were improved remarkably in patients with insufficient level of vitamin D. Vitamin D treatment in children with ADHD could be considered due to the exp and benefit of vitamin D in body This study examined whether adolescent females with attention-deficit/hyperactivity disorder ( ADHD ) are differentially responsive than their male counterparts to extended-release stimulant medications . This investigation may bear special importance for an adolescent ( as opposed to child ) population , because hormonal and metabolism differences between sexes are most likely to emerge at this time . Male ( n = 19 ) and female ( n = 16 ) adolescents , ages 16–19 with ADHD , participated in a r and omized , double-blind crossover study evaluating the effectiveness of osmotic-release methylpheni date , extended release amphetamine salts , placebo , and routine limited medication regimen . Medication efficacy was evaluated using ADHD symptom ratings from adolescent self-report and parent report , along with objective measures of inattention and hyperactivity/impulsivity during driving performance and neuropsychological tasks . Males and females were largely equivalent in impairment , and medication was similarly effective in reducing symptoms . No interactions were found between sex and medication on any measure of effectiveness or side effects . This finding suggests that the efficacy and tolerability of extended-release stimulant medications is equivalent for male and female adolescents with ADHD The cardinal symptoms of attention-deficit/hyperactivity disorder ( ADHD ) are inattention , hyperactivity and impulsivity . Etiologically , ADHD is mainly put down to genetic causes ; it entails a considerable range of psychosocial problems for those affected and their social environment . The parents of a total of 7,569 boys ( B ) and 7,267 girls ( G ) aged 3 - 17 who took part in the German Health Interview and Examination Survey for Children and Adolescents ( KiGGS ) answered a self-administered question naire including an ADHD diagnosis question and the  Strengths and Difficulties Question naire ( SDQ )  . In addition behavioural observations of 7,919 children ( aged 3 - 11 ) were carried out during the medical and physical tests . Participants whose parents reported that they had ever been given an ADHD diagnosis by a doctor or psychologist were classified as ADHD cases . Participants were classified as suspected cases of ADHD if they had a value of > or = 7 on the SDQ inattention/hyperactivity scale . ADHD had ever been diagnosed in 4.8 % of the children and adolescents altogether ( B : 7.7 % , G : 1.8 % ) . Another 4.9 % of the participants can be considered as suspected cases . Already 1.8 % of the preschoolers had been given an ADHD diagnosis . At primary school age ( 7 - 10 years old ) the frequency of diagnosis rises sharply . At age 11 - 17 , ADHD had ever been diagnosed in 1 in 10 boys and 1 in 43 girls . ADHD had been diagnosed significantly more frequently among participants of low socio-economic status ( SES ) than among participants of high SES . A diagnosis of ADHD is reported less often for migrants , they rank more frequently among the suspected cases . The discrepancy between confirmed and suspected cases of ADHD among migrants may point to lower diagnosis rates or lower utilization of medical services . The short- and long-term medical , social and health-economic effects of ADHD illustrate the major public health relevance of the disorder . As for prevention , the high share of genetic factors in ADHD etiology primarily suggests secondary prevention ( early support and early diagnosis ) and tertiary prevention measures . Further analysis of the KiGGS data could prospect ively identify risk groups more precisely and refine preventional approaches The present investigation examined the effects of methylpheni date on impulsivity in children with attention-deficit hyperactivity disorder ( ADHD ) . A task was design ed to measure empirically the ADHD child 's proclivity to blurt out incorrect answers before giving a final and /or correct response . Twenty-six ADHD children referred for double-blind placebo-controlled assessment of medication responsiveness and 14 non-ADHD controls were given a visual search word-matching task to assess impulsive responding . An analysis of covariance showed that ADHD children on methylpheni date made fewer impulsive errors than ADHD children on placebo . The control group made fewer impulsive errors than the ADHD children in the placebo condition , but the performance of the ADHD children on medication approximated the performance of the children without ADHD . These preliminary findings suggest that the word-matching task may be a useful tool for assessing impulsive responding and determining the benefits of stimulant medication on impulsivity . ( J Child Neurol 1993;8:157 - 163 ) BACKGROUND Attention-deficit/hyperactivity disorder ( ADHD ) is associated with a 3- to 4-fold increase in both driving-related accidents and associated injuries .  Methylpheni date ( MPH ) is the most commonly prescribed psychostimulant medication for ADHD . It has been demonstrated to improve performance on a driving simulator . This study investigated whether a once-daily , long-acting , osmotic , controlled-release MPH formulation improves the driving performance of ADHD adolescents while driving their own car on an actual road segment . METHODS Twelve ADHD-diagnosed male adolescent drivers ( mean age , 17.8 years ) prescribed a st  and ard  dose of 1.0 mg/kg ( if they were not already taking methylpheni date ) of controlled-release MPH participated in this repeated- measures crossover study . On 2 separate occasions ( off/on medication r and omized ) , participants drove a st and ard 16-mile road course incorporating rural , highway , and urban streets . A rater , blind to medication conditions , sat in the back seat and rated impulsive ( eg , " cutting off " another driver ) and inattentive ( eg , drove past design ated turn ) driving errors . RESULTS Impulsive driving errors were observed to occur rarely under both medication and no medication conditions . Inattentive driving errors were more common and were significantly reduced while the subject was on medication ( 4.6 versus 7.8 ; P < .01 ) . The improvement in driving performance ( change in number of errors recorded ) from first to second testing was positively correlated with medication dosage ( r = 0.60 ; P < .01 ) . CONCLUSIONS Once-daily controlled-release MPH improves real-life driving performance of adolescent males diagnosed with ADHD . In particular , it significantly reduces driving errors arising from inattention OBJECTIVE The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder ( ADHD ) , and whether neurofeedback is a viable alternative for stimulant medication , is still an intensely debated subject . The current r and omized controlled trial compared neurofeedback to ( 1 ) optimally titrated methylpheni date and ( 2 ) a semi-active control intervention , physical activity , to account for nonspecific effects . METHODS A multicenter 3-way parallel-group study with balanced r and omization was conducted . Children with a DSM-IV-TR diagnosis of ADHD , aged 7 - 13 years , were r and omly allocated to receive neurofeedback ( n = 39 ) , methylpheni date ( n = 36 ) , or physical activity ( n = 37 ) over a period of 10 - 12 weeks . Neurofeedback comprised theta/beta training on the vertex ( Cz ) . Physical activity consisted of moderate to vigorous intensity exercises . Neurofeedback and physical activity were balanced in terms of number ( ~30 ) and duration of sessions . A double-blind pseudor and omized placebo-controlled crossover titration procedure was used to determine an optimal dose in the methylpheni date intervention . Parent and teacher ratings on the Strengths and Difficulties Question naire ( SDQ ) and Strengths and Weaknesses of ADHD Symptoms and Normal Behavior ( SWAN ) were used to assess intervention outcomes . Data collection took place between September 2010 and March 2014 . RESULTS Intention-to-treat analyses revealed an improvement in parent-reported behavior on the SDQ and the SWAN Hyperactivity/Impulsivity scale , irrespective of received intervention ( ηp² = 0.21 - 0.22 , P ≤ .001 ) , whereas the SWAN Inattention scale revealed more improvement in children who received methylpheni date than neurofeedback and physical activity ( ηp² = 0.13 , P ≤ .001 ) . Teachers reported a decrease of ADHD symptoms on all measures for methylpheni date , but not for neurofeedback or physical activity ( range of ηp² = 0.14 - 0.29 , P < .001 ) . CONCLUSIONS The current study found that optimally titrated methylpheni date is superior to neurofeedback and physical activity in decreasing ADHD symptoms in children with ADHD . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01363544 The aim of this study was to determine drug-dependent effects on attention and motor activity in children with attention-deficit/hyperactivity disorder ( ADHD ) in a double-blind methylpheni date ( MPH ) trial using both subjective behavior ratings and objective measures of function . In particular , we were interested in the relationship between changes of those subjective and objective measures . A total of 44 ADHD children with the combined subtype completed a r and omized , double-blind , placebo-controlled , crossover trial with 2 doses of MPH ( 0.25 ; 0.5 mg/kg body weight ) and placebo . In each condition , computerized attention tasks were performed , teacher-behavior ratings were obtained , and actigraph data were collected in both clinical and naturalistic setting s. Trend tests revealed linear effects of MPH dose on actigraph data in the test session ( p = 0.02 ) and at school ( p = 0.001 ) , as well as on sustained attention ( p < 0.001 ) , while inhibitory control showed a quadratic dose-response curve ( p < 0.001 ) . Multivariate regression analyses revealed that changes of both , hyperactive-impulsive symptoms ( 28 % ) and inattentive symptoms ( 23 % ) could be explained by objective changes of motor activity . Thus , for clinical practice , it should be taken into account that behavior ratings of ADHD symptoms seemed to be predominantly influenced by changes of motor activity Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder ( ADHD ) clinical symptoms and neurocognitive function in a realistic clinical setting , and the differences in ADHD symptom improvement using different classifications of ADHD subtypes . Methods The Child Behavior Checklist ( CBCL ) was completed by parents of ADHD children at the initial visit . The  computerized Continuous Performance Test ( CPT ) , Swanson , Nolan , and Pelham , and Version IV Scale for ADHD ( SNAP-IV ) , and  ADHD Rating Scale ( ADHD-RS ) were performed at baseline , one month , three months , and six months later , respectively . Patient care including drug therapy was performed at the discretion of the psychiatrist . The ADHD patients were divided into DSM-IV subtypes ( Inattentive , Hyperactive-impulsive and Combined type ) , and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons . Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years ; 15 of them were inattentive type , 11 were hyperactive-impulsive type , and 24 were combined type . In addition , 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes . There were significant improvements in clinical symptoms of hyperactivity and inattention , and impulsivity performance in CPT during the 6-month treatment . The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression . Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients . Conclusions We found that ADHD symptoms , which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions , had improved significantly over 6 months under pragmatic treatments . The non-aggressive ADHD patients might have a higher potential for improving in CPT performance than aggressive ones . However , it warrant further investigation whether the different classifications of ADHD patients could be valid for predicting the improvements in ADHD patients ' clinical symptoms and neurocognitive performance Thirteen children ( ages 5.6 to 11.2 years ) with autism and symptoms of attention-deficit hyperactivity disorder ( ADHD ) participated in a double-blind , placebo-controlled crossover study of methylpheni date ( 0.3 and 0.6 mg/kg per dose ) . Eight subjects responded positively , based upon a minimum 50 % decrease on the Conners Hyperactivity Index . Ratings of stereotypy and inappropriate speech , which are often associated with autistic core features , also decreased . However , no changes were found on the Child Autism Rating Scale , a global assessment of autistic symptomotology . Significant adverse side effects occurred in some children including social withdrawal and irritability , especially at the 0.6 mg/kg dose . Results suggest that methylpheni date can be efficacious for children with autism and ADHD symptoms . However , this group of children seems to be particularly susceptible to adverse side effects Objective The present study investigated the predictive power of anxiety , IQ , severity of ADHD and parental depression  on the outcome of treatment in children with ADHD . Method Fifty children with ADHD ( ages 8–12 ) were r and omized to a 10-week treatment of methylpheni date or to a treatment of methylpheni date combined with multimodal behavior therapy . Prior to treatment predictors were assessed . Outcome was assessed separately for parents and teachers on a composite measure of inattentive , hyperactive , oppositional- and conduct disorder symptoms . Results There was neither a significant difference between the two treatments at baseline nor did treatment condition predict outcome . Therefore the data were collapsed across the two treatments . A combination of anxiety and IQ predicted teacher-rated outcome , explaining 18 % of the variance . Higher anxiety and higher IQ ’s indicated better treatment outcome . There were no significant predictors of the parent-rated outcome . Conclusion This study showed a small but significant predictive effect of IQ and anxiety on treatment outcome in children with ADHD . Clinical implication sThis study supports the idea that for the treatment of ADHD children with comorbid anxiety and higher IQ respond better to the two most used treatments for ADHD The efficacy and side effects of buspirone compared with methylpheni date ( MPH ) in the treatment of children with attention-deficit/hyperactivity disorder ( ADHD ) . A total of 34 children with ADHD as defined by DSM-IV-TR were r and omized to buspirone or methylpheni date dosed on weight-adjusted basis at buspirone ( 0.5 mg/kg/day ) and methylpheni date ( 0.3–1 mg/kg/day ) for a 6-week double-blind clinical trial . The principle measures of outcome were the teacher and parent ADHD Rating Scale . The side effects were assessed by the special side effect checklist of each drug . In both groups , the scores of teacher and parent ADHD Rating Scale significantly declined on the 6th week as compared to baseline ( p = 0.001 ) . These effects were observed in the subscales too . No significant differences were observed between the two protocol s on the total scores of parent and teacher ADHD Rating Scale , but methylpheni date was superior to buspirone in decreasing the symptoms of inattention . The side effects of buspirone were mild and rare in comparison with MPH . Buspirone has a favorable side-effects profile . It also has clinical ly and statistically significant impacts on improving the ADHD symptoms in children . These preliminary findings of the efficacy of buspirone in children with ADHD need large and cross-over studies OBJECTIVE To assess the effect of methylpheni date on the diagnosis of oppositional-defiant disorder ( ODD ) comorbid with attention-deficit hyperactivity disorder ( ADHD ) . METHOD We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylpheni date . At least one month after ADHD symptoms were under control , ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes ( P-ChIPS ) . RESULTS Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylpheni date for ADHD . CONCLUSION Methylpheni date seems to be an effective treatment for ODD , as well as for ADHD itself . The implication s for the treatment of patients with ODD not comorbid with ADHD needs further investigation Children ( 6 - 12 years ) with attention-deficit hyperactivity disorder ( ADHD ) being treated with methylpheni date and st and ard behavior therapy for more than 6 months , whose parents reported no improvement in behavior and academic learning , were r and omly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo . Outcome was measured at 3 and 6 months after treatment using a self- assessment checklist completed by the parents . Statistically significant improvement was found in the treatment group compared with the placebo group ( P < .01 ) in the following measures : restlessness , aggressiveness , completing work , and academic performance . Statistically significant improvement was not found at 3 months of treatment between groups but was evident at 6 months of treatment ( P < .05 ) with inattention , impulsiveness , and cooperation with parents and teachers . Distractibility failed to show improvement . Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables Stimulant medication efficacy was evaluated in 14 children with attention-deficit hyperactivity disorder and IQs of 48 to 74 in a double-blind crossover study of two methylpheni date doses and placebo . Dependent measures included behavioral ratings , work output , measures of learning , attention and impulsivity , and direct observation of peer social interactions . Nine children ( 64 % ) were methylpheni date -responders , based upon the Conners Hyperactivity Index . Significant gains in on-task behavior and attentional skills were noted with methylpheni date in comparison to placebo . No improvement on measures of learning or social interactions were observed . Results extend and replicate previous research conducted by the authors Objective . To assess effects of OROS methylpheni date on cognitive and academic tasks in 9 to 12 year olds with attention-deficit/hyperactivity disorder ( ADHD ) . Methods . A double-blind , within-subject , crossover design was used to compare OROS methylpheni date with placebo in a laboratory classroom setting on several cognitive and academic tasks for 68 children who met r and omization criteria . Results . Performance on the following measures was significantly better when children received individually optimized OROS methylpheni date than placebo :  math fluency and accuracy measured by the Permanent Product Math Test , ADHD symptoms observed in the laboratory setting , computerized indices of attention and impulsivity as measured by the Test of Variables of Attention ( TOVA ) , and visual — spatial working memory ( Finger Windows Backwards ) . Study medication was well tolerated ; adverse events were generally consistent with previous reports . Conclusions . OROS methylpheni date improves performance on measures of attention and vigilance , behavior , and working memory in a laboratory school setting in 9 to 12 year olds with ADHD OBJECTIVE Impairments associated with attention-deficit/hyperactivity disorder ( ADHD ) and noncompliance are prevalent in children with autism spectrum disorder ( ASD ) . However , ADHD response to stimulants is well below rates in typically developing children , with frequent side effects . Group studies of treatments for noncompliance are rare in ASD . We examined individual and combined-effectiveness of atomoxetine ( ATX ) and parent training ( PT ) for ADHD symptoms and noncompliance . METHOD In a 3-site , 10-week , double-blind , 2 × 2 trial of ATX and PT , 128 children ( ages 5 - 14 years ) with ASD and ADHD symptoms were r and omized to  ATX , ATX+PT , placebo+PT , or placebo . ATX was adjusted to optimal dose ( capped at 1.8 mg/kg/day ) over 6 weeks and maintained for 4 additional weeks . Nine PT sessions were provided . Primary outcome measures were the parent-rated DSM ADHD symptoms on the Swanson , Nolan and Pelham ( SNAP ) scale and Home Situations Question naire ( HSQ ) . RESULTS On the SNAP , ATX , ATX+PT and placebo+PT were each superior to placebo ( effect sizes 0.57 - 0.98 ; p values of .0005 , .0004 , and .025 , respectively ) . For noncompliance , ATX and ATX+PT were superior to placebo ( effect sizes 0.47 - 0.64 ; p values .03 and .0028 , respectively ) . ATX was associated with decreased appetite but was otherwise well tolerated . CONCLUSION Both ATX and PT result ed in significant improvement on ADHD symptoms , whereas ATX ( both alone and combined with PT ) was associated with significant decreases on measures of noncompliance . ATX appears to have a better side effects profile than psychostimulants in the population with ASD . CLINICAL TRIAL REGISTRATION INFORMATION Atomoxetine , Placebo and Parent Management Training in Autism ; http:// clinical trials.gov/ ; NCT00844753 Background The treatment of children with attention deficit hyperactivity disorder ( ADHD ) and Tourette syndrome ( TS ) has been problematic because methylpheni date (MPH)—the most commonly used drug to treat ADHD — has been reported to worsen tics and because clonidine (CLON)—the most commonly prescribed alternative — has unproven efficacy . Methods The authors conducted a multicenter , r and omized , double-blind clinical trial in which 136 children with ADHD and a chronic tic disorder were r and omly administered CLON alone , MPH alone , combined CLON + MPH , or placebo ( 2 × 2 factorial design ) . Each subject participated for 16 weeks ( weeks 1–4 CLON/placebo dose titration , weeks 5–8 added MPH/placebo dose titration , weeks 9–16 maintenance therapy ) . Results Thirty-seven children were administered MPH alone , 34 were administered CLON alone , 33 were administered CLON + MPH , and 32 were administered placebo . For our primary outcome measure of ADHD ( Conners Abbreviated Symptom Question naire – Teacher ) , significant improvement occurred for subjects assigned to CLON ( p < 0.002 ) and those assigned to MPH ( p < 0.003 ) . Compared with placebo , the greatest benefit occurred with combined CLON + MPH ( p < 0.0001 ) . CLON appeared to be most helpful for impulsivity and hyperactivity ; MPH appeared to be most helpful for inattention . The proportion of individual subjects reporting a worsening of tics as an adverse effect was no higher in those treated with MPH ( 20 % ) than those being administered CLON alone ( 26 % ) or placebo ( 22 % ) . Compared with placebo , measured tic severity lessened in all active treatment groups in the following order : CLON + MPH , CLON alone , MPH alone . Sedation was common with CLON treatment ( 28 % reported moderate or severe sedation ) , but otherwise the drugs were tolerated well , including absence of any evident cardiac toxicity . Conclusions Methylpheni date and clonidine ( particularly in combination ) are effective for ADHD in children with comorbid tics . Prior recommendations to avoid methylpheni date in these children because of concerns of worsening tics are unsupported by this trial
No trials reported serious adverse events .
Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low- , medium- or high-dose ranges .
We found that short-term use of methylpheni date might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication , although the low quality of evidence means that we can not be certain of the true magnitude of any effect .
There was no evidence that methylpheni date has a negative impact on the core symptoms of ASD , or that it improves social interaction , stereotypical behaviours , or overall ASD .
BACKGROUND Children with autistic spectrum disorder ( ASD ) frequently present with inattention , impulsivity and hyperactivity , which are the cardinal symptoms of attention deficit hyperactivity disorder ( ADHD ) .
The effectiveness of methylpheni date , a commonly used ADHD treatment , is therefore of interest in these children .
OBJECTIVES To assess the effects of methylpheni date for symptoms of ADHD ( inattention , impulsivity and hyperactivity ) and ASD ( impairments in social interaction and communication , and repetitive , restricted or stereotypical behaviours ) in children and adolescents aged 6 to 18 years with ASD .