title: Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial.
abstract: OBJECTIVE
  Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days.
  
  
  RESULTS
  A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group.
  
  
  CONCLUSIONS
  The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.
authors.affiliation: Clinical Psychiatry, Department of Psychiatry, Columbia University, New York, USA. LarryLGreenhill@cs.com
authors.forename: L L
authors.initials: LL
authors.lastname: Greenhill
authors.forename: J M
authors.initials: JM
authors.lastname: Swanson
authors.forename: B
authors.initials: B
authors.lastname: Vitiello
authors.forename: M
authors.initials: M
authors.lastname: Davies
authors.forename: W
authors.initials: W
authors.lastname: Clevenger
authors.forename: M
authors.initials: M
authors.lastname: Wu
authors.forename: L E
authors.initials: LE
authors.lastname: Arnold
authors.forename: H B
authors.initials: HB
authors.lastname: Abikoff
authors.forename: O G
authors.initials: OG
authors.lastname: Bukstein
authors.forename: C K
authors.initials: CK
authors.lastname: Conners
authors.forename: G R
authors.initials: GR
authors.lastname: Elliott
authors.forename: L
authors.initials: L
authors.lastname: Hechtman
authors.forename: S P
authors.initials: SP
authors.lastname: Hinshaw
authors.forename: B
authors.initials: B
authors.lastname: Hoza
authors.forename: P S
authors.initials: PS
authors.lastname: Jensen
authors.forename: H C
authors.initials: HC
authors.lastname: Kraemer
authors.forename: J S
authors.initials: JS
authors.lastname: March
authors.forename: J H
authors.initials: JH
authors.lastname: Newcorn
authors.forename: J B
authors.initials: JB
authors.lastname: Severe
authors.forename: K
authors.initials: K
authors.lastname: Wells
authors.forename: T
authors.initials: T
authors.lastname: Wigal
mesh_terms: D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage* / Q000494:pharmacology; D012044:Regression Analysis
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate