title: Clinical gains from including both dextroamphetamine and methylphenidate in stimulant trials.
abstract: OBJECTIVE
  The purpose of this study was to investigate clinical gains from including both dextroamphetamine and methylphenidate in stimulant trials.
  
  
  METHODS
  Thirty-six medication-naïve children ages 9-14 years diagnosed with attention-deficit/hyperactivity disorder (ADHD) were enrolled for 6 weeks in a crossover trial, with 2 weeks of methylphenidate, dextroamphetamine, and placebo, in a randomly assigned, counterbalanced sequence. Outcome measures constituted a computer-based continuous performance test combined with a motion tracking system (Qb Test) and an ADHD questionnaire rated by parents and teachers.
  
  
  RESULTS
  Group analyses found significant treatment effects of similar size for the two stimulants on both outcome measures. Single-subject analyses revealed that each stimulant produced a favourable response in 26 children; however, an individual child frequently responded qualitatively or quantitatively differently to the two stimulants. By including both stimulants in the trial, the number of favorable responders increased from 26 (72%) to 33 (92%). In children with favorable responses of unequal strength to the two stimulants, a shift from inferior drug to best drug was associated with a 64% mean increase in the overall response strength score, as measured by the ADHD questionnaire.
  
  
  CONCLUSIONS
  The likelihood of a favorable response and optimal response strength is increased by including both stimulants in the stimulant trial. The study was first registered in clinical trials 28 September 2010. Clinical Trials.gov Identifier: NCT01220440.
authors: 1 Østfold Hospital Trust , Neuropsychiatric Unit, Fredrikstad, Norway .
authors: Bjørn E
authors: BE
authors: Ramtvedt
authors: Elisabeth
authors: E
authors: Røinås
authors: Henning S
authors: HS
authors: Aabech
authors: Kjetil S
authors: KS
authors: Sundet
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D018592:Cross-Over Studies; D003913:Dextroamphetamine / Q000008:administration & dosage / Q000627:therapeutic use*; D003936:Diagnosis, Computer-Assisted; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D010290:Parents; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D003913:Dextroamphetamine
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