title: Methylphenidate in children with oppositional defiant disorder and both comorbid chronic multiple tic disorder and ADHD.
abstract: Our primary objective was to determine if immediate-release methylphenidate is an effective treatment for oppositional defiant disorder diagnosed from mother's report in children with both chronic multiple tic disorder and attention-deficit hyperactivity disorder (ADHD). Children (n = 31) aged 6 to 12 years received placebo and 3 doses of methylphenidate twice daily for 2 weeks each under double-blind conditions and were assessed with ratings scales and laboratory measures. Results indicated significant improvement in both oppositional and ADHD behaviors with medication; however, the magnitude of treatment effect varied considerably as a function of disorder (ADHD > Oppositional behaviors), informant (teacher > mother), assessment instrument, and specific oppositional behavior (rebellious > disobeys rules). Drug response was comparable with that in children (n = 26) who did not have diagnosed oppositional defiant disorder, but comorbidity appeared to alter the perceived benefits for ADHD according to mother's report. Methylphenidate is an effective short-term treatment for oppositional behavior in children with comorbid ADHD and chronic multiple tic disorder.
authors.affiliation: Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, New York 11794-8790, USA. kenneth.gadow@stonybrook.edu
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Gadow
authors.forename: Edith E
authors.initials: EE
authors.lastname: Nolan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Sverd
authors.forename: Joyce
authors.initials: J
authors.lastname: Sprafkin
authors.forename: Jayne
authors.initials: J
authors.lastname: Schneider
mesh_terms: D000367:Age Factors; D000374:Aggression / Q000187:drug effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D002648:Child; D015897:Comorbidity; D004185:Disability Evaluation; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage*; D009483:Neuropsychological Tests; D010919:Placebos; D012737:Sex Factors; D013981:Tic Disorders / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D010919:Placebos; D008774:Methylphenidate