title: Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD.
abstract: BACKGROUND
  The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations.
  
  
  METHODS
  One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents) and teachers (CGI-Teachers), while side effects were assessed using the Barkley Side Effects Rating Scale (SERS).
  
  
  RESULTS
  The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p < 0.005). These "somatic/physical" side effects did not correlate with CGI-Parents or CGI-Teachers. However, the side effects of "irritability", "proneness to crying", and "anxiousness" showed significant relationships with CGI-Parents. These "mood/anxiety" side effects showed no significant correlations with the CGI-Teachers.
  
  
  CONCLUSIONS
  The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Lee
authors.forename: Natalie
authors.initials: N
authors.lastname: Grizenko
authors.forename: Venkataramana
authors.initials: V
authors.lastname: Bhat
authors.forename: Sarojini
authors.initials: S
authors.lastname: Sengupta
authors.forename: Anna
authors.initials: A
authors.lastname: Polotskaia
authors.forename: Ridha
authors.initials: R
authors.lastname: Joober
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001294:Attitude to Health; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D018592:Cross-Over Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D010290:Parents / Q000523:psychology*; D012720:Severity of Illness Index; D013663:Teaching; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate