Adverse Reactions to Methylphenidate Treatment for Attention-Deficit/Hyperactivity Disorder: Structure and Associations with Clinical Characteristics and Symptom Control

Edmund J. S. Sonuga-Barke, David Coghill, Timothy Wigal, Marc DeBacker, James Swanson

    Research output: Contribution to journalArticle

    43 Citations (Scopus)

    Abstract

    Background: Methylphenidate (MPH)-related adverse events are well characterized. Their predictors and their relationship with therapeutic effects are less well understood. Here we examine these issues in relation to two long-acting formulations.

    Method: Comparison of Methylphenidates in the Analog Classroom Setting (COMACS) was made in a large (n = 184) placebo-controlled trial comparing Equasym XL (R)/Metadate CD (R), Concerta (R), and placebo (PLA) using a Laboratory School protocol. Therapeutic effects were measured using direct observation, scores on a simple math productivity task and parent ratings. Parents also completed the Barkley Stimulant Side Effect Rating Scale (BSSERS).

    Results: The BSSERS had six factors: Emotionality, sleep/appetite, disengaged, dizzy, uninterested, and aches. Treatment effects were seen only for emotionality (which improved) and sleep and appetite (which worsened). Adverse events were not predictable from personal and clinical characteristics of patients. Sleep/appetite adverse events were not associated with therapeutic effects. Improvements in attention-deficit/hyperactivity disorder (ADHD) and emotionality were correlated.

    Discussion: The results support a narrow conceptualization of MPH adverse events with problems restricted to appetite and sleep. These effects were not predictable on the basis of available information and may be due to an underlying mechanism rather distinct from those determining therapeutic effects.

    Original languageEnglish
    Pages (from-to)683-690
    Number of pages8
    JournalJournal of Child and Adolescent Psychopharmacology
    Volume19
    Issue number6
    DOIs
    Publication statusPublished - Dec 2009

    Keywords

    • DEFICIT-HYPERACTIVITY-DISORDER
    • DOSE-RESPONSE
    • CROSSOVER TRIAL
    • CHILDREN
    • ADHD
    • GROWTH
    • MEDICATIONS
    • SAFETY
    • MTA
    • TOLERABILITY

    Cite this

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    title = "Adverse Reactions to Methylphenidate Treatment for Attention-Deficit/Hyperactivity Disorder: Structure and Associations with Clinical Characteristics and Symptom Control",
    abstract = "Background: Methylphenidate (MPH)-related adverse events are well characterized. Their predictors and their relationship with therapeutic effects are less well understood. Here we examine these issues in relation to two long-acting formulations.Method: Comparison of Methylphenidates in the Analog Classroom Setting (COMACS) was made in a large (n = 184) placebo-controlled trial comparing Equasym XL (R)/Metadate CD (R), Concerta (R), and placebo (PLA) using a Laboratory School protocol. Therapeutic effects were measured using direct observation, scores on a simple math productivity task and parent ratings. Parents also completed the Barkley Stimulant Side Effect Rating Scale (BSSERS).Results: The BSSERS had six factors: Emotionality, sleep/appetite, disengaged, dizzy, uninterested, and aches. Treatment effects were seen only for emotionality (which improved) and sleep and appetite (which worsened). Adverse events were not predictable from personal and clinical characteristics of patients. Sleep/appetite adverse events were not associated with therapeutic effects. Improvements in attention-deficit/hyperactivity disorder (ADHD) and emotionality were correlated.Discussion: The results support a narrow conceptualization of MPH adverse events with problems restricted to appetite and sleep. These effects were not predictable on the basis of available information and may be due to an underlying mechanism rather distinct from those determining therapeutic effects.",
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    Adverse Reactions to Methylphenidate Treatment for Attention-Deficit/Hyperactivity Disorder: Structure and Associations with Clinical Characteristics and Symptom Control. / Sonuga-Barke, Edmund J. S.; Coghill, David; Wigal, Timothy; DeBacker, Marc; Swanson, James.

    In: Journal of Child and Adolescent Psychopharmacology, Vol. 19, No. 6, 12.2009, p. 683-690.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Adverse Reactions to Methylphenidate Treatment for Attention-Deficit/Hyperactivity Disorder: Structure and Associations with Clinical Characteristics and Symptom Control

    AU - Sonuga-Barke, Edmund J. S.

    AU - Coghill, David

    AU - Wigal, Timothy

    AU - DeBacker, Marc

    AU - Swanson, James

    PY - 2009/12

    Y1 - 2009/12

    N2 - Background: Methylphenidate (MPH)-related adverse events are well characterized. Their predictors and their relationship with therapeutic effects are less well understood. Here we examine these issues in relation to two long-acting formulations.Method: Comparison of Methylphenidates in the Analog Classroom Setting (COMACS) was made in a large (n = 184) placebo-controlled trial comparing Equasym XL (R)/Metadate CD (R), Concerta (R), and placebo (PLA) using a Laboratory School protocol. Therapeutic effects were measured using direct observation, scores on a simple math productivity task and parent ratings. Parents also completed the Barkley Stimulant Side Effect Rating Scale (BSSERS).Results: The BSSERS had six factors: Emotionality, sleep/appetite, disengaged, dizzy, uninterested, and aches. Treatment effects were seen only for emotionality (which improved) and sleep and appetite (which worsened). Adverse events were not predictable from personal and clinical characteristics of patients. Sleep/appetite adverse events were not associated with therapeutic effects. Improvements in attention-deficit/hyperactivity disorder (ADHD) and emotionality were correlated.Discussion: The results support a narrow conceptualization of MPH adverse events with problems restricted to appetite and sleep. These effects were not predictable on the basis of available information and may be due to an underlying mechanism rather distinct from those determining therapeutic effects.

    AB - Background: Methylphenidate (MPH)-related adverse events are well characterized. Their predictors and their relationship with therapeutic effects are less well understood. Here we examine these issues in relation to two long-acting formulations.Method: Comparison of Methylphenidates in the Analog Classroom Setting (COMACS) was made in a large (n = 184) placebo-controlled trial comparing Equasym XL (R)/Metadate CD (R), Concerta (R), and placebo (PLA) using a Laboratory School protocol. Therapeutic effects were measured using direct observation, scores on a simple math productivity task and parent ratings. Parents also completed the Barkley Stimulant Side Effect Rating Scale (BSSERS).Results: The BSSERS had six factors: Emotionality, sleep/appetite, disengaged, dizzy, uninterested, and aches. Treatment effects were seen only for emotionality (which improved) and sleep and appetite (which worsened). Adverse events were not predictable from personal and clinical characteristics of patients. Sleep/appetite adverse events were not associated with therapeutic effects. Improvements in attention-deficit/hyperactivity disorder (ADHD) and emotionality were correlated.Discussion: The results support a narrow conceptualization of MPH adverse events with problems restricted to appetite and sleep. These effects were not predictable on the basis of available information and may be due to an underlying mechanism rather distinct from those determining therapeutic effects.

    KW - DEFICIT-HYPERACTIVITY-DISORDER

    KW - DOSE-RESPONSE

    KW - CROSSOVER TRIAL

    KW - CHILDREN

    KW - ADHD

    KW - GROWTH

    KW - MEDICATIONS

    KW - SAFETY

    KW - MTA

    KW - TOLERABILITY

    U2 - 10.1089/cap.2009.0024

    DO - 10.1089/cap.2009.0024

    M3 - Article

    VL - 19

    SP - 683

    EP - 690

    JO - Journal of Child and Adolescent Psychopharmacology

    JF - Journal of Child and Adolescent Psychopharmacology

    SN - 1044-5463

    IS - 6

    ER -