scholarly journals No Relation between Therapeutic Response to Methylphenidate and its Cardiovascular Side Effects in Children with Attention-Deficit/Hyperactivity Disorder

2008 ◽  
Vol 1 ◽  
pp. CMPed.S1010
Author(s):  
Venkataramana Bhat ◽  
Natalie Grizenko ◽  
Steven Sanche ◽  
Ridha Joober
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Mixed Model ◽  
Therapeutic Response ◽  
Double Blind ◽  
Mixed Model Analysis ◽  
Hyperactivity Disorder ◽  
Cardiovascular Side Effects ◽  
Response Groups ◽  
Underlying Mechanisms

Objective The aim of this study was to examine the relation between therapeutic response to methylphenidate (MPH) and its associated short term cardiovascular side effects (Systolic Blood Pressure-SBP, Diastolic Blood Pressure-DBP and Heart Rate-HR changes) in children with ADHD, based on the hypothesis that these parameters share common underlying mechanisms. Method A double-blind placebo-controlled crossover clinical trial of children 6 to 12 years old diagnosed with ADHD was done. The children were given one week of 0.5 mg/kg MPH and one week of placebo (divided into two equal doses, given twice every day). On the morning of the third day of each week, Blood Pressure (BP) and HR were recorded immediately before (at time 0) and after (at time 10 and 45 minutes) administration of MPH. Children were grouped into 4 categories according to their therapeutic response (large, moderate, mild or no response) to MPH. A mixed model analysis of variance was performed to determine whether response groups were different with regard to cardiovascular side effects. Results All variables were comparable among the four groups 10 min after treatment with MPH and with placebo. Small but significant (p < 0.001) increases were seen in SBP (3.65 mm of Hg) and DBP (3.99 mm of Hg) 45 minutes after administration of MPH. A small but significant decrease in HR (3.3 beats per minute) was observed 45 min after administration of placebo. No significant differences in SBP, DBP and HR were found between response groups. Conclusions MPH causes a small but significant change in BP at 45 minutes after administration. No changes in HR were observed with MPH at 45 minutes. Responders to MPH treatment do not differ from non-responders in occurrence of BP and HR changes, at least within 45 minutes after administration and with the MPH dosage used in the study.

Rapid cardiovascular effects of dexamethasone in rabbits with meconium-induced acute lung injury

2008 ◽  
Vol 86 (11) ◽  
pp. 804-814 ◽  
Author(s):  
Daniela Mokra ◽  
Ingrid Tonhajzerova ◽  
Juraj Mokry ◽  
Anna Drgova ◽  
Maria Petraskova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Side Effects ◽  
Rabbit Model ◽  
Intratracheal Instillation ◽  
Cardiovascular Effects ◽  
Meconium Aspiration Syndrome ◽  
Cardiovascular Side Effects ◽  
Acute Side Effects ◽  
Systemic Glucocorticoids

Glucocorticoids may improve lung function in newborns with meconium aspiration syndrome (MAS), but information on the acute side effects of glucocorticoids in infants is limited. In this study using a rabbit model of MAS, we addressed the hypothesis that systemic administration of dexamethasone causes acute cardiovascular changes. Adult rabbits were treated with 2 intravenous doses of dexamethasone (0.5 mg/kg each) or saline at 0.5 h and 2.5 h after intratracheal instillation of human meconium or saline. Animals were oxygen-ventilated for 5 h after the first dose of treatment. Blood pressure, heart rate, and short-term heart rate variability (HRV) were analyzed during treatment, for 5 min immediately after each dose, and for the 5 h of the experiment. In the meconium-instilled animals, dexamethasone increased blood pressure, decreased heart rate, increased HRV parameters, and caused cardiac arrhythmia during and immediately after administration. In the saline-instilled animals, the effect of dexamethasone was inconsistent. In these animals, the acute effects of dexamethasone on blood pressure and cardiac rhythm were reversed after 30 min, whereas heart rate continued to decrease and HRV parameters continued to increase for 5 h after the first dose of dexamethasone. These effects were more pronounced in meconium-instilled animals. If systemic glucocorticoids are used in the treatment of MAS, cardiovascular side effects of glucocorticoids should be considered.

scholarly journals Effectiveness and Tolerability of Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder

2011 ◽  
Vol 3 ◽  
pp. CMT.S6615
Author(s):  
Caroline Bodey
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Side Effects ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Treatment Plan ◽  
Immediate Release ◽  
Height Velocity ◽  
Comprehensive Treatment ◽  
Hyperactivity Disorder ◽  
Cardiovascular Side Effects

Attention deficit hyperactivity disorder (ADHD) is a common condition and important for the affected individual, their family and society. It manifests with pervasive symptoms of hyperactivity, impulsivity and inattention. In many children with ADHD these symptoms persist into adolescence and adulthood. Drug treatment with psychostimulants, including methylphenidate, is an important part of a comprehensive treatment plan for children with severe ADHD that includes psychosocial, behavioural and educational advice and interventions. Methylphenidate is a central nervous system stimulant, whose mechanism of action is thought to be due to an increase in catecholamines in areas of the brain concerned with motivation and reward. Methylphendiate is available in short acting (immediate release) and longer acting (modified release) forms. Pharmacotherapy for ADHD is in three stages: initiation, maintenance and termination. The efficacy of methylphenidate in terms of reducing core symptoms is 70% as compared to placebo. This efficacy is maintained for at least 24 months. Methylphenidate generally has a favourable side effect profile. The most significant side effects include appetite suppression with an initial deceleration in height velocity, cardiovascular side effects that are not clinically significant in children with no adverse cardiac history, and tics. Methylphenidate is generally well tolerated and liked by children and adolescents with ADHD, who appreciate the benefits that medication has on their behaviour.

scholarly journals Acute memory and psychotomimetic effects of cannabis and tobacco both ‘joint’ and individually: a placebo-controlled trial

2017 ◽  
Vol 47 (15) ◽  
pp. 2708-2719 ◽  
Author(s):  
C. Hindocha ◽  
T. P. Freeman ◽  
J. X. Xia ◽  
N. D. C. Shaban ◽  
H. V. Curran
Keyword(s):  
Verbal Memory ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Controlled Trial ◽  
Subjective Effects ◽  
Preliminary Evidence ◽  
Interactive Effects ◽  
Double Blind ◽  
Mixed Model Analysis ◽  
Psychotomimetic Effects

BackgroundCannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research.MethodThe individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions.ResultsCannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of ‘stoned’ and ‘dizzy’ induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure.ConclusionsRelative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.

Evaluation of the Effect of Timolol Alone and in Combination with Hydrochlorothiazide and Amiloride in the Treatment of Mild to Moderate Arterial Hypertension: A Double-Blind, Controlled Study

1976 ◽  
Vol 51 (s3) ◽  
pp. 529s-531s ◽  
Author(s):  
G. Muiesan ◽  
B. Magnani ◽  
E. Agabiti-Rosei ◽  
C. Alicandri ◽  
E. Ambrosioni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Side Effects ◽  
Moderate Essential Hypertension ◽  
Fixed Dose ◽  
Controlled Study ◽  
Double Blind ◽  
Combination Tablet ◽  
Group A ◽  
Group B

1. The effects of timolol alone and in combination with a fixed dose of hydrochlorothiazide and amiloride have been studied in a double-blind, controlled study in fifty-four patients with mild to moderate essential hypertension. 2. After a 4 weeks placebo period patients were randomly assigned to enter groups receiving timolol alone (group A), hydrochlorothiazide + amiloride (group B) or timolol + hydrochlorothiazide + amiloride (group C). Each treatment was carried out for 6 weeks. 3. The use of timolol (10 mg), hydrochlorothiazide (25 mg) and amiloride (2·5 mg) in a combination tablet given twice daily gave better control of blood pressure in patients with mild to moderate essential hypertension than did equivalent dosages of timolol alone or of hydrochlorothiazide and amiloride. 4. Clinical and laboratory side effects were minimal.

Double-Blind Crossover Study of Carbuterol and Salbutamol in Bronchial Asthma

1981 ◽  
Vol 9 (4) ◽  
pp. 261-267 ◽  
Author(s):  
N P Misra ◽  
U C Tiwari ◽  
G T Khemchandani
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Bronchial Asthma ◽  
Oral Route ◽  
Double Blind ◽  
Bronchodilator Effect ◽  
Minimum Number ◽  
A Minor ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

A double-blind crossover comparative study between carbuterol 3 mg thrice daily, carbuterol 2 mg thrice daily and salbutamol 4 mg thrice daily by the oral route was conducted in thirty patients suffering from bronchial asthma, selected at random, with more than 20% reduction in airway obstruction following isoprenaline inhalation. Each patient received all three drugs consecutively, each for 6 days, with a wash-out period in-between. The present study established a relative superiority of carbuterol 3 mg thrice daily over carbuterol 2 mg and salbutamol 4 mg thrice daily as evidenced by a higher percentage of subjective improvement (78.8%), preference shown by more cases (17/27), and need of additional drugs in a minimum number of cases (6/27), and significant improvement in FEV and MMEFR (p < 0.05). Salbutamol is known to produce tachycardia and a rise in blood pressure. There were no adverse side-effects on the cardiovascular system but unlike salbutamol, carbuterol produced a fall in pulse rate and blood pressure which should make carbuterol more acceptable to patients, especially on prolonged usage. There was an absence of significant side-effects on the haemopoietic system and kidneys; other side-effects observed with all three types of treatment were of a minor nature and did not necessitate withdrawal of the drug. Thus, carbuterol is an effective and safe selective beta-adrenergic stimulant, is relatively free from side-effects, and has a sustained bronchodilator effect, an advantage in therapeutic application, and is, as a result, a new effective drug in the management of bronchial asthma.

scholarly journals Effects of Piracetam as an Adjuvant Therapy on Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Kaveh Alavi ◽  
Elham Shirazi ◽  
Maryam Akbari ◽  
Zahra Shahrivar ◽  
Fatemeh-Sadat Noori ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Placebo Group ◽  
Side Effects ◽  
Adjuvant Therapy ◽  
Attention Deficit ◽  
Controlled Study ◽  
Double Blind ◽  
Children With Adhd ◽  
Double Blind Placebo ◽  
Hyperactivity Disorder

Background: Stimulants are highly effective in controlling symptoms of Attention-deficit/hyperactivity disorder (ADHD), but 30% of individuals with ADHD do not respond to them or cannot tolerate their side effects; thus, alternative treatment approaches need to be considered. Objectives: To evaluate the effect and safety of piracetam as an adjuvant therapy plus methylphenidate (MPH) in children with ADHD. Methods: Thirty-six children with ADHD (6-16 years old), admitted to three academic outpatient child psychiatric clinics in the second half of 2015, were randomly assigned to the “methylphenidate plus piracetam group” and the “methylphenidate plus placebo” group, in a double-blind, placebo-controlled study, for 6 weeks. The “Conner’s Parents’ Rating Scale-Revised (CPRS-R), Children Symptom Inventory-4 (CSI-4), Clinical Global Impression-Improvement scale (CGI-I), and Children’ Global Assessment Scale (CGAS) were completed at baseline and at the ends of the third and the sixth week, and the New York State Psychiatric Institute side effect forms were completed weekly, as outcome measures. Results: The level of improvement in CPRS-R, CSI-4, and CGI-I scales were significantly higher in the “methylphenidate plus piracetam” group compared with the “methylphenidate plus placebo” group. Side effects were not remarkable in any group. Conclusions: Piracetam as a short-term adjuvant treatment to methylphenidate can have considerable therapeutic effect and safety profile in children with ADHD and deserves further exploration to assess its potentialities in ADHD treatment.

Association between sleep disturbance and nocturnal blood pressure profiles by a linear mixed model analysis: the Nagahama study

2019 ◽  
Vol 61 ◽  
pp. 104-109 ◽  
Author(s):  
Takeshi Matsumoto ◽  
Yasuharu Tabara ◽  
Kimihiko Murase ◽  
Kazuya Setoh ◽  
Takahisa Kawaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sleep Disturbance ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Model Analysis ◽  
Mixed Model Analysis ◽  
Linear Mixed Model Analysis ◽  
Nocturnal Blood Pressure ◽  
Pressure Profiles

ADVERSE SIDE EFFECTS OF METHYLPHENIDATE AMONG MENTALLY RETARDED CHILDREN WITH ADHD

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. A64-A64
Author(s):  
Benjamin L. Handen ◽  
Heidi Feldman ◽  
Amy Gosling ◽  
Anna Marie Breaux ◽  
Sarah McAuliffe
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Side Effects ◽  
Attention Deficit ◽  
Mentally Retarded ◽  
Activity Level ◽  
Double Blind Study ◽  
Double Blind ◽  
Adverse Side Effects ◽  
Hyperactivity Disorder ◽  
Mentally Retarded Children

The adverse side effects of methylphenidate were evaluated in 27 children with attention deficit hyperactivity disorder and IQs of 48 to 74 who participated in a double-blind study of two doses of methylphenidate and placebo. A checklist of 13 side effects, generated from the Physician's Desk Reference, was completed by teachers. Rates of irritability, anxiety, moodiness, and activity level decreased significantly when comparing the placebo with drug conditions. However, medication for six (22%) of the children was discontinued because of the appearance of motor tics (three children) and severe social withdrawal (two children), suggesting that mentally retarded children with attention deficit hyperactivity disorder may be at a greater risk for developing these side effects than the nonretarded population.

A Controlled Study on the Anti-Hypertensive Effect of a new β-Adrenoreceptor-Blocking Drug, Metoprolol, in Combination with Chlorthalidone

1976 ◽  
Vol 51 (s3) ◽  
pp. 521s-523s ◽  
Author(s):  
A. Jäättelä ◽  
K. Pyörälä
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Side Effects ◽  
Moderate Hypertension ◽  
Moderate Essential Hypertension ◽  
Controlled Study ◽  
Blocking Drug ◽  
Double Blind ◽  
Basic Treatment

1. A double-blind cross-over evaluation of the anti-hypertensive effect of metoprolol vs placebo was carried out in a series of twenty-three patients with mild or moderate essential hypertension who were receiving 25 mg of chlorthalidone daily as their basic treatment. An individually determined dose of metoprolol (75–300 mg) was used. 2. Metoprolol, as compared with placebo, produced a statistically significant reduction of blood pressure, both in supine and standing positions. 3. During the double-blind cross-over study mild side effects were more common at the beginning of metoprolol/chlorthalidone treatment than during placebo/chlorthalidone, but these tended to diminish or disappear with time. 4. Metoprolol in combination with chlorthalidone appears to be an effective and well-tolerated treatment for mild and moderate hypertension in patients not responding to chlorthalidone alone.

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