Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Preschoolers with ADHD improve with low doses of medication

18.10.2006
The first long-term, large-scale study designed to determine the safety and effectiveness of treating preschoolers who have attention deficit/hyperactivity disorder (ADHD) with methylphenidate (Ritalin) has found that overall, low doses of this medication are effective and safe.

However, the study found that children this age are more sensitive than older children to the medication's side effects and therefore should be closely monitored. The 70-week, six-site study was funded by the National Institutes of Health's National Institute of Mental Health (NIMH) and was described in several articles in the November 2006 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

"The Preschool ADHD Treatment Study, or PATS, provides us with the best information to date about treating very young children diagnosed with ADHD," said NIMH Director Thomas R. Insel, MD. "The results show that preschoolers may benefit from low doses of medication when it is closely monitored, but the positive effects are less evident and side-effects are somewhat greater than previous reports in older children."

Methylphenidate is the most commonly prescribed medication to treat children diagnosed with ADHD. But its use for children younger than 6 years has not been approved by the Food and Drug Administration. And until PATS, very few studies--and no large-scale ones--have been conducted to collect reliable, consistent data to help guide practitioners treating preschoolers with ADHD.

The 303 preschoolers enrolled in the study ranged in age from 3 to 5 years. The children and their parents participated in a pre-trial, 10-week behavioral therapy and training course. Only those children with the most extreme ADHD symptoms who did not improve after the behavioral therapy course and whose parents agreed to have them treated with medication were included in the medication study. In the first part of the medication study, the children took a range of doses from a very low amount of 3.75 mg daily of methylphenidate, administered in three equal doses, up to 22.5 mg/day. By comparison, doses for school-aged children usually range from 15 to 50 mg total daily.

The study then compared the effectiveness of methylphenidate to placebo. It found that the children taking methylphenidate had a more marked reduction of their ADHD symptoms compared to children taking a placebo, and that different children responded best to different doses.

"The best dose to reduce ADHD symptoms varied substantially among the children, but the average across the whole group was as low as 14 mg per day," said lead author Laurence Greenhill, M.D., of Columbia University/New York State Psychiatric Institute. "Preschoolers with ADHD may need only a low dose of methylphenidate initially, but they may need to take a higher dose later on to maintain the drug's effectiveness."

To ensure the safety of the very young children involved, the study was governed by a strict set of ethical standards and additional review boards. The children's health was monitored carefully and repeatedly throughout the study's duration. Their parents were repeatedly consulted for consent prior to every step of the program. The researchers also reviewed the teacher ratings of the children who attended preschool at various stages in the study.

Similar to 1999 results found in NIMH's Multimodal Treatment Study of Children with ADHD (MTA study), and other studies on school-aged children, the medication did appear to slow the preschoolers' growth rates. Throughout the duration of the study, the children grew about half an inch less in height and weighed about 3 pounds less than expected, based on average growth rates established prior to the study.

Currently, no data exist that track long-term growth rate changes among preschoolers with ADHD who are medicated with methylphenidate. However, a five-year-long follow-up study is underway to track the children's physical, cognitive, and behavioral development, as well as health care services the family is using to care for the child. Those data will be available in two to three years.

Finally, 89 percent of the children tolerated the drug well, but 11 percent--about 1 in 10 children--had to drop out of the study as a result of intolerable side effects. For example, while some children lost weight, weight loss of 10 percent or more of the child's baseline weight was considered a severe enough side effect for the investigators to discontinue the medication. Other side effects included insomnia, loss of appetite, mood disturbances such as feeling nervous or worried, and skin-picking behaviors. Despite concerns that stimulants may increase blood pressure or pulse, any changes seen in the children's blood pressure or pulse were minimal.

"The study shows that preschoolers with severe ADHD symptoms can benefit from the medication, but doctors should weigh that benefit against the potential for these very young children to be more sensitive than older children to the medication's side effects, and monitor use closely," concluded Dr. Greenhill.

Colleen Labbe | EurekAlert!
Further information:
http://www.nih.gov

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Scientist invents way to trigger artificial photosynthesis to clean air

26.04.2017 | Materials Sciences

Ammonium nitrogen input increases the synthesis of anticarcinogenic compounds in broccoli

26.04.2017 | Agricultural and Forestry Science

SwRI-led team discovers lull in Mars' giant impact history

26.04.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>