title: Response to methylphenidate in children with attention deficit hyperactivity disorder and manic symptoms in the multimodal treatment study of children with attention deficit hyperactivity disorder titration trial.
abstract: OBJECTIVE
  Recent reports raise concern that children with attention deficit hyperactivity disorder (ADHD) and some manic symptoms may worsen with stimulant treatment. This study examines the response to methylphenidate in such children.
  
  
  METHODS
  Data from children participating in the 1-month methylphenidate titration trial of the Multimodal Treatment Study of Children with ADHD were reanalyzed by dividing the sample into children with and without some manic symptoms. Two "mania proxies" were constructed using items from the Diagnostic Interview Schedule for Children (DISC) or the Child Behavior Checklist (CBCL). Treatment response and side effects are compared between participants with and without proxies.
  
  
  RESULTS
  Thirty-two (11%) and 29 (10%) participants fulfilled criteria for the CBCL mania proxy and DISC mania proxy, respectively. Presence or absence of either proxy did not predict a greater or lesser response or side effects.
  
  
  CONCLUSIONS
  Findings suggest that children with ADHD and manic symptoms respond robustly to methylphenidate during the first month of treatment and that these children are not more likely to have an adverse response to methylphenidate. Further research is needed to explore how such children will respond during long-term treatment. Clinicians should not a priori avoid stimulants in children with ADHD and some manic symptoms.
authors.affiliation: Columbia University/New York State Psychiatric Institute, New York, New York 10032, USA. cg168@columbia.edu
authors.forename: Cathryn A
authors.initials: CA
authors.lastname: Galanter
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Carlson
authors.forename: Peter S
authors.initials: PS
authors.lastname: Jensen
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Greenhill
authors.forename: Mark
authors.initials: M
authors.lastname: Davies
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Shirley Z
authors.initials: SZ
authors.lastname: Chuang
authors.forename: Glen R
authors.initials: GR
authors.lastname: Elliott
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.forename: John S
authors.initials: JS
authors.lastname: March
authors.forename: Lily
authors.initials: L
authors.lastname: Hechtman
authors.forename: William E
authors.initials: WE
authors.lastname: Pelham
authors.forename: James M
authors.initials: JM
authors.lastname: Swanson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D016009:Chi-Square Distribution; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic / Q000379:methods* / Q000706:statistics & numerical data; D012044:Regression Analysis
chemical_list: D008774:Methylphenidate