Testing tic suppression: comparing the effects of dexmethylphenidate to no medication in children and adolescents with attention-deficit/hyperactivity disorder and Tourette's disorder.
OBJECTIVE
The aim of this study was to conduct a pilot study testing whether single-dose, immediate-release dexmethylphenidate (dMPH) can facilitate tic suppression in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and Tourette's disorder (TD) or chronic tic disorders. The primary hypothesis is that dMPH will improve behaviorally reinforced tic suppression in a standard tic suppression paradigm (TSP).


METHODS
Ten children with ADHD and TD were given dMPH on one visit and no medication on another, using a random crossover design. On both days, following a baseline period, subjects were reinforced for suppressing tics using a standard TSP.


RESULTS
Thirteen subjects were enrolled; 10 subjects (mean age 12.7 +/- 2.6; 90% male) completed all study procedures. Relative to the no-medication condition, tics were reduced when children were given a single dose of dMPH. Behavioral reinforcement of tic suppression resulted in lower rates of tics compared to baseline, but dMPH did not enhance this suppression.


CONCLUSIONS
Preliminary results indicate replication of prior studies of behavioral tic suppression in youths with TD and without ADHD. In addition, our findings indicate tic reduction (and not tic exacerbation) with acute dMPH challenge in children and adolescents with ADHD and TD.
Lyon
Gholson J
GJ
Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York, New York 10016, USA.
Samar
Stephanie M
SM
Conelea
Christine
C
Trujillo
Marcel R
MR
Lipinski
Christina M
CM
Bauer
Christopher C
CC
Brandt
Bryan C
BC
Kemp
Joshua J
JJ
Lawrence
Zoe E
ZE
Howard
Jonathan
J
Castellanos
F Xavier
FX
Woods
Douglas
D
Coffey
Barbara J
BJ
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000494:pharmacology; D002648:Child; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D064699:Dexmethylphenidate Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000494:pharmacology*; D010865:Pilot Projects; D012054:Reinforcement, Psychology; D020323:Tics / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D005879:Tourette Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology
D000697:Central Nervous System Stimulants; D064699:Dexmethylphenidate Hydrochloride; D008774:Methylphenidate
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