Differential effectiveness of methylphenidate and Adderall in school-age
youths with attention-deficit/hyperactivity disorder
by
Manos MJ, Short EJ, Findling RL
Case Western Reserve University (CWRU) School of Medicine, Cleveland, OH,
USA.
J Am Acad Child Adolesc Psychiatry 1999 Jul; 38(7):813-9
ABSTRACT
OBJECTIVE: To compare the effectiveness of a single dose of Adderall (q.d.)
with that of 2 daily doses of methylphenidate (b.i.d.; MPH) as a treatment for
attention-deficit/hyperactivity disorder (ADHD) in youths ranging in age from 5
to 17 years. Forty-two youths treated with MPH were compared with 42 youths
treated with Adderall. Subjects were matched for age, sex, and DSM-IV diagnostic
subtype. METHOD: Youths were assigned to the Adderall or MPH condition by their
prescribing physician. All youths were evaluated under 5 conditions, including
baseline, placebo, 5 mg, 10 mg, and 15 mg. The best dose was assigned prior to
breaking the medication blind and was assigned by the consensus of the
psychologist and psychiatrist. Subjective ratings by both teachers and parents
were examined for dosage level effects and medication type effects. RESULTS:
Best dose was always superior to baseline and placebo conditions. No differences
between MPH and Adderall were observed on either teacher or parent ratings of
behavior. CONCLUSIONS: Both MPH and Adderall have been shown to be effective
treatments for children with ADHD. Both medications appear to improve teachers'
and parents' ratings of behavior. Single-dose treatments of Adderall appear to
be as effective as 2 daily doses of MPH and therefore increase the possibility
of managing treatment without involving the school in medication administration.
In addition, youths who have previously been unsuccessfully treated with MPH
because of adverse side effects or poor response may be successfully treated
with Adderall.
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