title: Methylphenidate and comorbid anxiety disorder in children with both chronic multiple tic disorder and ADHD.
abstract: OBJECTIVE
  To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD).
  
  
  METHODS
  Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial with rating scales and laboratory measures.
  
  
  RESULTS
  The +ANX group obtained more severe parent, teacher, and child ratings of anxiety and more severe parent ratings of depression, tics, oppositional defiant disorder (ODD), and peer aggression than the -ANX group. Treatment with short-term MPH-IR was associated with improvement in ADHD, ODD, and peer aggression in the +ANX group. When controlling for ODD severity, there were no apparent group differences in therapeutic response to MPH-IR in children ±ANX. There was little evidence that MPH-IR contributed to improvement in anxiety or depression symptoms in the +ANX group. There was some indication that children with comorbid anxiety may differentially experience greater increase in systolic blood pressure (0.5 mg/kg of MPH-IR > placebo).
  
  
  CONCLUSIONS
  Findings suggest that the co-occurrence of diagnosed CMTD+ADHD+ANX represents a particularly troublesome clinical phenotype, at least in the home setting. Comorbid anxiety disorder was not associated with a less favorable response to MPH-IR in children with ADHD+CMTD, but replication with larger samples is warranted before firm conclusions can be drawn about potential group differences.
authors.affiliation: Stony Brook University, Stony Brook, NY 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
mesh_terms: D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D018579:Patient Selection; D012720:Severity of Illness Index; D013981:Tic Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate