Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD.

@article{Greenhill2006EfficacyAS,
  title={Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD.},
  author={Laurence Lee Greenhill and Scott H. Kollins and Howard B. Abikoff and James T. McCracken and Mark A. Riddle and James M. Swanson and James J. McGough and Sharon B. Wigal and Timothy L. Wigal and Benedetto Vitiello and Anne M Skrobala and Kelly Posner and Jaswinder Kaur Ghuman and Charles E. Cunningham and Mark Davies and Shirley Z Chuang and Thomas B Cooper},
  journal={Journal of the American Academy of Child and Adolescent Psychiatry},
  year={2006},
  volume={45 11},
  pages={
          1284-93
        }
}
OBJECTIVE The Preschool ADHD Treatment Study (PATS) was a NIMH-funded, six-center, randomized, controlled trial to determine the efficacy and safety of immediate-release methylphenidate (MPH-IR), given t.i.d. to children ages 3 to 5.5 years with attention-deficit/hyperactivity disorder (ADHD). METHOD The 8-phase, 70-week PATS protocol included two double-blind, controlled phases, a crossover-titration trial followed by a placebo-controlled parallel trial. The crossover-titration phase's… 
Effectiveness of Methylphenidate in the 10-Month Continuation Phase of the Preschoolers with ADHD Treatment Study (PATS)
ABSTRACT Objective: The aim of this study was to examine immediate-release methylphenidate effectiveness during the 10-month open-label continuation phase of the Preschoolers with
Rationale, design, and methods of the Preschool ADHD Treatment Study (PATS).
TLDR
The PATS adds to a limited literature and improves the understanding of the safety and efficacy of MPH in the treatment of preschoolers with ADHD, but changes in the design and problems in implementation of this study impose some specific limitations that need to be addressed in future studies.
Randomized, placebo-controlled, crossover study of methylphenidate for attention-deficit/hyperactivity disorder symptoms in preschoolers with developmental disorders.
TLDR
The predominant direction of response in these preschoolers with both ADHD and PDD/ID favored MPH, even though the response was more subtle and variable than in older and typically developing children.
Safety and tolerability of methylphenidate in preschool children with ADHD.
TLDR
Methylphenidate 3- to 5-year-old children with attention-deficit/hyperactivity disorder (ADHD) during 1 year of treatment with methylphenidate (MPH) suffered from emotional outbursts, difficulty falling asleep, repetitive behaviors/thoughts, appetite decrease, and irritability, while parents spontaneously reported moderate to severe AEs.
New Findings from the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS)
103 THE FIRST SEVEN PAPERS in Part Two of this book report new findings from the 6-site Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). The PATS was designed to
Methylphenidate effects on functional outcomes in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS).
TLDR
Preschoolers with ADHD treated with MPH for 4 weeks improve in some aspects of functioning, and additional improvements might require longer treatment, higher doses, and/or intensive behavioral treatment in combination with medication.
Randomized, Double-Blind, Placebo-Controlled, Flexible-Dose Titration Study of Methylphenidate Hydrochloride Extended-Release Capsules (Aptensio XR) in Preschool Children with Attention-Deficit/Hyperactivity Disorder
TLDR
Results demonstrate MPH-MLR efficacy in preschool children and a safety profile consistent with known AEs of methylphenidate when used for ADHD.
Pharmacokinetics of methylphenidate in preschoolers with attention-deficit/hyperactivity disorder.
TLDR
Age significantly affected absorption and metabolism of MPH, so that preschool children had greater exposure than school-aged children to the same weight-adjusted dose, and additional studies should be performed to characterize age-related differences in PK properties of MPH.
Prospective, naturalistic, pilot study of open-label atomoxetine treatment in preschool children with attention-deficit/hyperactivity disorder.
TLDR
This open-label pilot study provides preliminary evidence of effectiveness and tolerability of atomoxetine for treating ADHD in preschool children, although double-blind, randomized, placebo-controlled studies are needed to confirm this.
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References

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Rationale, design, and methods of the Preschool ADHD Treatment Study (PATS).
TLDR
The PATS adds to a limited literature and improves the understanding of the safety and efficacy of MPH in the treatment of preschoolers with ADHD, but changes in the design and problems in implementation of this study impose some specific limitations that need to be addressed in future studies.
Efficacy of methylphenidate among preschool children with developmental disabilities and ADHD.
TLDR
It is suggested that preschool children with developmental disabilities and ADHD respond to MPH at rates similar to those of school-age children with mental retardation and ADHD, however, this population appears to be especially susceptible to adverse drug side effects.
Safety and tolerability of methylphenidate in preschool children with ADHD.
TLDR
Methylphenidate 3- to 5-year-old children with attention-deficit/hyperactivity disorder (ADHD) during 1 year of treatment with methylphenidate (MPH) suffered from emotional outbursts, difficulty falling asleep, repetitive behaviors/thoughts, appetite decrease, and irritability, while parents spontaneously reported moderate to severe AEs.
Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial.
TLDR
The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg.
Pharmacogenetics of methylphenidate response in preschoolers with ADHD.
TLDR
Emerging evidence suggests the potential for understanding the individual variability of response to and side effects of ADHD medications from the study of genetics, although additional research is required before these findings are proven to have clinical utility.
A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD.
TLDR
The authors' carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication for ADHD symptoms, and may have provided modest advantages for non-ADHD symptom and positive functioning outcomes.
Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment.
  • J. SwansonH. Kraemer M. Wu
  • Medicine, Psychology
    Journal of the American Academy of Child and Adolescent Psychiatry
  • 2001
TLDR
These secondary analyses confirm the primary findings and clarify clinical decisions about the choice between multimodal and unimodal treatment with medication.
Stimulant-related reductions of growth rates in the PATS.
TLDR
Risks of reduced growth rates should be balanced against expected benefits when preschool-age children are treated with stimulant medication.
Evaluation of the relative effectiveness of methylphenidate and cognitive behavior modification in the treatment of kindergarten-aged hyperactive children
TLDR
It was shown that hyperactive children became less symptomatic over time and the data did not provide evidence indicating that any of the treatments studied was more effective than any other or than no treatment at all.
The Use of Psychotropic Medication in Preschoolers: Indications, Safety, and Efficacy
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  • 1998
TLDR
Because data about psychotropic drug safety and efficacy in adults have not been extended to children, new psychopharmacological research is required before clinicians can use these agents to treat psychiatric disorders in the preschool age-group.
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