Immediate-release methylphenidate for ADHD in children with comorbid chronic multiple tic disorder.
OBJECTIVE
To examine the safety and efficacy of immediate-release methylphenidate (MPH-IR) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children (ages 6-12 years) with Tourette's syndrome (96%) or chronic motor tic disorder (4%).


METHODS
Two cohorts of prepubertal children (N = 71) received placebo and three doses of MPH (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks each, under double-blind conditions as part of their involvement in a long-term observation study (1989-2004). Treatment effects were assessed with an extensive battery of parent-, teacher-, child-, and physician-completed rating scales and laboratory tasks.


RESULTS
MPH-IR effectively suppressed ADHD, oppositional defiant disorder, and peer aggression behaviors. There was no evidence that MPH-IR altered the overall severity of tic disorder or obsessive-compulsive disorder behaviors. Teacher ratings indicated that MPH-IR therapy decreased tic frequency and severity.


CONCLUSIONS
MPH-IR appears to be a safe and effective short-term treatment for ADHD in the majority of children with chronic tic disorder; nevertheless, the possibility of tic exacerbation in susceptible individuals warrants careful monitoring of all patients.
Gadow
Kenneth D
KD
Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, NY 11794-8790, USA. kenneth.gadow@stonybrook.edu
Sverd
Jeffrey
J
Nolan
Edith E
EE
Sprafkin
Joyce
J
Schneider
Jayne
J
D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D015897:Comorbidity; D006801:Humans; D008774:Methylphenidate / Q000008:administration & dosage*; D012107:Research Design; D013981:Tic Disorders / Q000188:drug therapy* / Q000453:epidemiology
D000697:Central Nervous System Stimulants; D008774:Methylphenidate