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A clinical protocol for determining methylphenidate dosage levels in ADHD

J.B. Hale

A.M. Bradley

M. Byrnes

D.L. Coury

L. Lennie

B.L. Trommer

Despite the widespread use of methylphenidate (MPH) in the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD), physicians often must rely on anecdotal observations and subjective reports to titrate MPH regimens. Many double-blind placebo-controlled medication trials have demonstrated treatment efficacy; however, the development of an effective clinical protocol that is reliably sensitive to dose-response relationships and can be used in office practice remains elusive. Using a double-blind placebo clinical protocol, and rank order analysis of instruments sensitive to ADHD symptoms, the MPH response patterns of 50 children with ADHD were analyzed using repeated measures multivariate analysis of variance. Several instru ments were sensitive in predicting response, and others revealed trends in the expected direction. The rank order rating analyses revealed robust differences between active drug conditions and placebo. Using cognitive rank order ratings, linear and quadratic MPH response patterns were identified, with the best dose for each group significantly different from that obtained for all other conditions.

Journal of Attention Disorders, Vol. 2, No. 1, 19-30 (1997)
DOI: 10.1177/108705479700200102


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