Analog classroom assessment of Adderall in children with ADHD.

OBJECTIVE This was a randomized, double-blind, crossover study of 30 children with attention-deficit/hyperactivity disorder (ADHD) that evaluated the time course effects of four doses of Adderall (5, 10, 15, and 20 mg), an inactive control (placebo), and a positive control (clinical dose of methylphenidate). METHOD For each treatment condition, a capsule was administered in the morning and assessments were performed in an analog classroom setting every 1.5 hours across the day. Subjective (teacher ratings of deportment and attention) and objective (scores on math tests) measures were obtained for each classroom session, and these measures were used to evaluate time-response and dose response effects of Adderall. RESULTS For doses of Adderall greater than 5 mg, significant time course effects were observed. Rapid improvements on teacher ratings and math performance were observed by 1.5 hours after administration, and these effects dissipated by the end of the day. The specific pattern of time course effects depended on dose: the time of peak effects and the duration of action increased with dose of Adderall. CONCLUSIONS This documentation of efficacy in a controlled study supports the addition of Adderall to the armamentarium of psychotropic medications for the treatment of ADHD. The differences in time-response patterns of Adderall and methylphenidate may help tailor treatment to meet specific clinical needs of different children with ADHD.

[1]  J. Swanson,et al.  Medication treatment strategies in the MTA Study: relevance to clinicians and researchers. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[2]  M Davies,et al.  The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[3]  J. Swanson,et al.  Pemoline effects on children with ADHD: a time-response by dose-response analysis on classroom measures. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[4]  R. Harrington,et al.  Brief home-based intervention with young suicide attempters and their families , 1995 .

[5]  D. Black,et al.  Secondary Prevention of Attempted Suicide in Adolescence. , 1995 .

[6]  P. Jensen,et al.  Introduction to the special section: efficacy and effectiveness in studies of child and adolescent psychotherapy. , 1995, Journal of consulting and clinical psychology.

[7]  J. Swanson,et al.  NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  C. Popper.  The Story of Four Salts , 1994 .

[9]  Francis M. Crinella,et al.  Effect of Stimulant Medication on Children with Attention Deficit Disorder: A “Review of Reviews” , 1993 .

[10]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[11]  L. Greenhill.  Ritalin: Theory and Patient Management , 1991 .

[12]  R. Barkley.  The ecological validity of laboratory and analogue assessment methods of ADHD symptoms , 1991, Journal of abnormal child psychology.

[13]  N. Jacobson,et al.  Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. , 1991, Journal of consulting and clinical psychology.

[14]  J. Sergeant,et al.  Sustained attention and pervasive hyperactivity. , 1991, Journal of child psychology and psychiatry, and allied disciplines.

[15]  Mark D. Hoover,et al.  Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder: a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline. , 1990, Pediatrics.

[16]  J. Sergeant,et al.  Additive factor method applied to psychopathology with special reference to childhood hyperactivity. , 1990, Acta psychologica.

[17]  G. Fritz,et al.  Attempted suicide in adolescence: A review and critique of the literature , 1989 .

[18]  A. Kazdin,et al.  The hopelessness scale for children: psychometric characteristics and concurrent validity. , 1986, Journal of consulting and clinical psychology.

[19]  W. Eichlseder.  Ten years of experience with 1,000 hyperactive children in a private practice. , 1985, Pediatrics.

[20]  L. Arnold,et al.  Methylphenidate vs dextroamphetamine vs caffeine in minimal brain dysfunction: controlled comparison by placebo washout design with Bayes' analysis. , 1978, Archives of general psychiatry.

[21]  J. Swanson,et al.  Time-response analysis of the effect of stimulant medication on the learning ability of children referred for hyperactivity. , 1978, Pediatrics.

[22]  R. Sprague,et al.  Methylphenidate in hyperkinetic children: differences in dose effects on learning and social behavior. , 1977, Science.

[23]  B. Winsberg,et al.  Dextroamphetamine and methylphenidate in the treatment of hyperactive-aggressive children. , 1974, Pediatrics.

[24]  P. Wender.  Minimal brain dysfunction in children , 1971 .

[25]  C. Conners,et al.  THE EFFECTS OF METHYLPHENIDATE ON SYMPTOMATOLOGY AND LEARNING IN DISTURBED CHILDREN. , 1963, The American journal of psychiatry.

[26]  C. Bradley.  Benzedrine and dexedrine in the treatment of children's behavior disorders. , 1950, Pediatrics.

[27]  C. Bradley.  THE BEHAVIOR OF CHILDREN RECEIVING BENZEDRINE , 1937 .