title: Pharmacotherapy of the Preschool ADHD Treatment Study (PATS) Children Growing Up.
abstract: OBJECTIVE
  To describe the long-term psychopharmacological treatment of children first diagnosed with attention-deficit/hyperactivity disorder (ADHD) as preschoolers.
  
  
  METHODS
  In a systematic, prospective, naturalistic follow-up, 206 (68.0%) of the 303 children who participated in the Preschool ADHD Treatment Study (PATS) were reassessed 3 years (mean age 7.4 years) and 179 (59.1%) were reassessed 6 years (mean age 10.4 years) after completion of the controlled study. Pharmacotherapy and clinical data were obtained from the parents. Pharmacotherapy was defined as use of a specific class of medication for at least 50% of the days in the previous 6 months.
  
  
  RESULTS
  At year 3, a total of 34.0% of the participants were on no pharmacotherapy, 41.3% were on stimulant monotherapy, 9.2% were on atomoxetine alone or with a stimulant, 8.3% were on an antipsychotic usually together with a stimulant, and the remaining 7.2% were on other pharmacotherapy; overall, 65.0% were on an indicated ADHD medication. At year 6, a total of 26.8% of the participants were on no pharmacotherapy, 40.2% were on stimulant monotherapy, 4.5% were on atomoxetine alone or with a stimulant, 13.4% were on an antipsychotic, and 15.1% were on other pharmacotherapy; overall, 70.9% were on an indicated ADHD medication. Antipsychotic treatment was associated with more comorbidity, in particular disruptive behavior disorders and pervasive development disorders, and a lower level of functioning.
  
  
  CONCLUSIONS
  In this study, the long-term pharmacotherapy of preschoolers with ADHD was heterogeneous. Although stimulant medication continued to be used by most children, about 1 child in 4 was off medication, and about 1 in 10 was on an antipsychotic.
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD. Electronic address: bvitiell@nih.gov.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
authors.affiliation: independent statistical contractor.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lazzaretto
authors.affiliation: Columbia University Medical Center and New York State Psychiatric Institute (NYSPI), New York.
authors.forename: Kseniya
authors.initials: K
authors.lastname: Yershova
authors.affiliation: New York University School of Medicine, New York.
authors.forename: Howard
authors.initials: H
authors.lastname: Abikoff
authors.affiliation: Columbia University Medical Center and New York State Psychiatric Institute (NYSPI), New York.
authors.forename: Natalya
authors.initials: N
authors.lastname: Paykina
authors.affiliation: University of California, Los Angeles.
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
authors.affiliation: University of California, Los Angeles.
authors.forename: James J
authors.initials: JJ
authors.lastname: McGough
authors.affiliation: Duke University School of Medicine, Durham, NC.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kollins
authors.affiliation: Columbia University Medical Center and New York State Psychiatric Institute (NYSPI), New York.
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Greenhill
authors.affiliation: University of California, Irvine when this work was conducted and now are with AVIDA Inc., Newport Beach, CA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Wigal
authors.affiliation: University of California, Irvine when this work was conducted and now are with AVIDA Inc., Newport Beach, CA.
authors.forename: Tim
authors.initials: T
authors.lastname: Wigal
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride
keywords: ADHD; medication; preschoolers; stimulant