title: Effectiveness of methylphenidate in the 10-month continuation phase of the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS).
abstract: OBJECTIVE
  The aim of this study was to examine immediate-release methylphenidate effectiveness during the 10-month open-label continuation phase of the Preschoolers with Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment Study (PATS).
  
  
  METHODS
  One hundred and forty preschoolers with ADHD, who had improved with acute immediate-release methylphenidate (IR-MPH) treatment, entered a 10-month, open-label medication maintenance at six sites. Assessments included the Clinical Global Impression-Severity (CGI-S), CGI-Improvement (CGI-I), Children's Global Assessment Scale (C-GAS), Swanson, Nolan, and Pelham Questionnaire (SNAP), Scale Strengths and Weaknesses of ADHD-Symptoms and Normal Behaviors (SWAN), Social Competence Scale, Social Skills Rating System (SSRS), and Parenting Stress Index-Short Form (PSI-SF).
  
  
  RESULTS
  For the 95 children who completed the 10-month treatment, improvement occurred on the CGI-S (p = 0.02), CGI-I (p < 0.01), C-GAS (p = 0.001), and SSRS (p = 0.01). SNAP and SWAN scores remained stable. Forty five children discontinued: 7 for adverse effects, 7 for behavior worsening, 7 for switching to long-acting stimulants, 3 for inadequate benefit, and 21 for other reasons. The mean MPH dose increased from 14.04 mg/day +/- SD 7.57 (0.71 +/- 0.38 mg/kg per day) at month 1 to 19.98 mg/day +/- 9.56 (0.92 +/- 0.40 mg/kg per day) at month 10.
  
  
  CONCLUSIONS
  With careful monitoring and gradual medication dose increase, most preschoolers with ADHD maintained improvement during long-term IR-MPH treatment. There was substantial variability in effective and tolerated dosing.
authors.affiliation: Child and Adolescent Treatment and Preventive Intervention Research Branch, National Institute of Mental Health, 6001 Executive Boulevard, Bethesda, MD 20892, USA. bvitiell@nail.nih.gov
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
authors.forename: Howard B
authors.initials: HB
authors.lastname: Abikoff
authors.forename: Shirley Z
authors.initials: SZ
authors.lastname: Chuang
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kollins
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
authors.forename: James M
authors.initials: JM
authors.lastname: Swanson
authors.forename: Tim
authors.initials: T
authors.lastname: Wigal
authors.forename: James J
authors.initials: JJ
authors.lastname: McGough
authors.forename: Jaswinder K
authors.initials: JK
authors.lastname: Ghuman
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wigal
authors.forename: Anne M
authors.initials: AM
authors.lastname: Skrobala
authors.forename: Mark
authors.initials: M
authors.lastname: Davies
authors.forename: Kelly
authors.initials: K
authors.lastname: Posner
authors.forename: Charles
authors.initials: C
authors.lastname: Cunningham
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Greenhill
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D010290:Parents / Q000523:psychology; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate