Double-blind assessment of stimulant medication for attention deficit disorder: A model for clinical application.

1983 ◽  
Vol 53 (3) ◽  
pp. 542-547 ◽  
Author(s):  
Christopher K. Varley ◽  
Eric W. Trupin
Keyword(s):  
Clinical Application ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Stimulant Medication ◽  
Double Blind

Responses to Methylphenidate and Varied Doses of Caffeine in Children with Attention Deficit Disorder

1981 ◽  
Vol 26 (6) ◽  
pp. 395-401 ◽  
Author(s):  
D. Garfinkel Barry ◽  
D. Webster Christopher ◽  
Leon Sloman
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Low Dose ◽  
Stimulant Medication ◽  
High Dose ◽  
Day Hospital ◽  
Double Blind ◽  
Treatment Conditions ◽  
Hospital Patients ◽  
Low Dosage

Six children with the diagnosis of Attention Deficit Disorder were treated as day hospital patients, using different stimulant medication. They were studied in a double-blind crossover experiment in which they received caffeine in low dose or in a high dose. Methylphenidate was added to both dosages, as well as administered alone. Results indicated that caffeine in low dosage when added to methylphenidate was superior to all other treatment conditions. Caffeine in low dosage could not be differentiated from 10 mg of methylphenidate. High dosage caffeine was not different from placebo or no-drug conditions. This study offers evidence to support a curvilinear pattern of dose-response for caffeine, in attenuating the behavioural manifestations of this syndrome.

Assessing and Treating Attention Deficit Disorder in Adolescents

1986 ◽  
Vol 149 (6) ◽  
pp. 710-715 ◽  
Author(s):  
S. P. Kutcher
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Dose Adjustment ◽  
Stimulant Medication ◽  
Daily Practice ◽  
Routine Clinical Practice ◽  
Double Blind ◽  
Research Findings ◽  
Assessment Strategies ◽  
Integrate Research

Psychiatric assessment strategies that integrate research findings with daily practice are necessary and clinically useful. This paper uses the example of an attention deficit disordered adolescent to illustrate how double-blind placebo controlled and multi-dose adjustment designs can be successfully implemented in routine clinical practice. These designs are especially valuable In evaluating the therapeutic effect of methylphenidate because of biases that may lead to clinical misuse of this stimulant medication.

Stimulant Medications in Adults with Attention Deficit Disorder

1984 ◽  
Vol 29 (5) ◽  
pp. 435-440 ◽  
Author(s):  
M. Gauthier
Keyword(s):  
Attention Deficit ◽  
Prospective Studies ◽  
Attention Deficit Disorder ◽  
Stimulant Medication ◽  
Case Reports ◽  
Firm Conclusion ◽  
Double Blind ◽  
Stimulant Medications ◽  
Persistent Disability

The long-term prospective studies done in the last two decades on children suffering from attention deficit disorder with hyperactivity (ADD-H) give evidence of persistent disability in a majority of them when they reach adulthood. The literature on the use of stimulant medication in adults suffering from attention deficit disorder, residual type (ADD-R), is critically reviewed. After optimistic case reports two controlled double-blind studies have recently showed contradictory results. Some adults appear clearly to be helped by stimulant medication, but more investigations, especially with children diagnosed in childhood and followed-up, are needed before any firm conclusion can be made about the usefulness or non-usefulness of stimulants in ADD-R. There, as it is the case in childhood, medication might be insufficient by itself and might have to be associated with other forms of treatment.

Classroom Social Interactions of Attention Deficit Disorder with Hyperactivity Children as a Function of Stimulant Medication

1987 ◽  
Vol 12 (1) ◽  
pp. 61-76 ◽  
Author(s):  
Jan L. Wallander ◽  
Stephen R. Schroeder ◽  
Joseph A. Michelli ◽  
C. Thomas Gualtieri
Keyword(s):  
Social Interactions ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Stimulant Medication

scholarly journals Effect of Stimulant Medication on Children with Attention Deficit Disorder: A “Review of Reviews”

1993 ◽  
Vol 60 (2) ◽  
pp. 154-162 ◽  
Author(s):  
James M. Swanson ◽  
Keith McBurnett ◽  
Tim Wigal ◽  
Linda J. Pfiffner ◽  
Marc A. Lerner ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Stimulant Medication ◽  
Symptomatic Improvement ◽  
University Of California ◽  
Average Effect ◽  
General Audience ◽  
Literature Synthesis ◽  
Review Of Reviews ◽  
The University

The University of California, Irvine ADD Center recently conducted a synthesis of the literature on the use of stimulants with children with attention deficit disorder (ADD), using a unique “review of reviews” methodology. In this article, we compare three reviews from each of three review types (traditional, meta-analytic, general audience) and illustrate how coding variables can highlight sources of divergence. In general, divergent conclusions stemmed from variations in goal rather than from variations in the sources selected to review. Across quantitative reviews, the average effect size for symptomatic improvement (.83) was twice that for benefits on IQ and achievement measures (.35). A summary of what should and should not be expected of the use of stimulants with ADD children, derived from the literature synthesis, is provided.

Response to Stimulant Medication across Six Measures of School-Related Performance in Children with ADHD and Disruptive Behavior

1992 ◽  
Vol 18 (1) ◽  
pp. 42-53 ◽  
Author(s):  
Steven R. Forness ◽  
James M. Swanson ◽  
Dennis P. Cantwell ◽  
Donald Guthrie ◽  
Rhonda Sena
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Classroom Management ◽  
Attention Deficit ◽  
Stimulant Medication ◽  
Dosage Level ◽  
Social Progress ◽  
Response To Treatment ◽  
Child Behaviors ◽  
Double Blind ◽  
Hyperactivity Disorder

Children with attention deficit hyperactivity disorder display disruptive behavioral disorders that tend to interfere with academic and social progress and that may respond only partially to classroom management and motivational approaches. Although stimulant medication is seen as a necessary adjunct to treatment in many cases, measurement of response to such treatment is often quite problematic. The present study provides findings on response to treatment with methylphenidate (Ritalin) across six measures of cognitive, academic, and social functioning in 71 boys, ages 7 to 11 years, with attention deficit hyperactivity disorder. Optimal response to this drug was determined in double-blind, placebo, crossover trials, and measurement of response focused on procedures similar to those in actual practice. Response ranged from approximately 18 to 71% across the six measures, suggesting that whether a child can be considered a responder to methylphenidate depends greatly on choice of outcome measure. A clinically therapeutic dosage level for each subject was also used to examine dose effects, and factor analytic results suggest that three of the six measures appeared to tap child behaviors quite different from those measured by traditional means.

Aspartame, Behavior, and Cognitive Function in Children With Attention Deficit Disorder

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Bennett A. Shaywitz ◽  
Colleen M. Sullivan ◽  
George M. Anderson ◽  
Sheila M. Gillespie ◽  
Barbara Sullivan ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Rating Scale ◽  
Wisconsin Card Sorting Test ◽  
Cognitive Tests ◽  
Card Sorting ◽  
Symptom Scale ◽  
Double Blind ◽  
Behavior Rating Scale ◽  
Monoamine Metabolite

Objective. To determine the effects of large doses of aspartame on behavior, cognition, and monoamine metabolism in children with attention deficit disorder. Design. A randomized, double-blind, placebo-controlled crossover study of unmedicated children meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed) criteria for attention deficit disorder. Setting. Behavioral assessments were performed in the child's home by their parents and in the classroom by a teacher. Cognitive tests were administered and blood drawing was performed during a 2-day inpatient admission to our Children's Study Center. Interventions. Administration of aspartame (single morning dose, 34 mg/kg) or placebo for alternate 2-week periods. Main outcome measures. Behavioral and cognitive tests included the Matching Familiar Figures Test (MFFT), Children's Checking Task (CCT), the Airplane Test, the Wisconsin Card Sorting Test (WCST), the Subjects Treatment Emergent Symptom Scale (STESS), the Multigrade Inventory for Teachers (MIT), and the Conners Behavior Rating Scale. Blood was drawn for complete blood cell count and liver function tests, as well as amino acid, methanol, formate, serotonin, and monoamine metabolite analyses, and urine was collected for measurement of catecholamine and monoamine metabolite excretion. Results. No clinically significant differences between aspartame and placebo were found for the STESS, MIT, or Conners ratings, or for the MFFT, CCT, WCST, or Air-plane cognition tests. Also, no differences were noted for any of the biochemical measures, except for the expected increase in plasma phenylalanine and tyrosine following aspartame. Conclusions. The findings indicate that aspartame at greater than 10 times usual consumption has no effect on the cognitive and behavioral status of children with attention deficit disorder. In addition, aspartame does not appear to affect urinary excretion rates of monoamines and metabolites.

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