OBJECTIVE:Methylphenidate (MPH) is commonly used to treat attention-deficit/hyperactivity disorder (ADHD) in all children, including those with velocardiofacial syndrome (VCFS). Yet concerns have been raised regarding its safety and efficacy in VCFS. The goal of this study was to examine the safety and efficacy of MPH in children with VCFS. METHODS:Thirty-four children and adolescents with VCFS and ADHD participated in a randomized, controlled trial with a 2:1 ratio of MPH versus placebo. All subjects underwent a cardiological evaluation before and after MPH administration. The primary outcome measure was prefrontal cognitive performance following a single dose of MPH or placebo. A follow-up assessment was conducted after a 6-month treatment with MPH. RESULTS: Compared with placebo, single MPH administration was associated with a more robust improvement in prefrontal cognitive performance, including achievements in the Hearts and Flowers executive function task and the visual continuous performance task. After 6 months of treatment, a 40% reduction in severity of ADHD symptoms was reported by parents on the Revised Conners Rating Scale. All subjects treated with MPH reported at least one side effect, but it did not necessitate discontinuation of treatment. MPH induced an increase in heart rate and blood pressure that was usually minor, but was clinically significant in two cases. No differences in response to MPH were observed between catechol-O-methyltransferase Met versus Val carriers. CONCLUSION: The use of MPH in children with VCFS appears to be effective and relatively safe. A comprehensive cardiovascular evaluation for children with VCFS before and during stimulant treatment is recommended.
RCT Entities:
OBJECTIVE:Methylphenidate (MPH) is commonly used to treat attention-deficit/hyperactivity disorder (ADHD) in all children, including those with velocardiofacial syndrome (VCFS). Yet concerns have been raised regarding its safety and efficacy in VCFS. The goal of this study was to examine the safety and efficacy of MPH in children with VCFS. METHODS: Thirty-four children and adolescents with VCFS and ADHD participated in a randomized, controlled trial with a 2:1 ratio of MPH versus placebo. All subjects underwent a cardiological evaluation before and after MPH administration. The primary outcome measure was prefrontal cognitive performance following a single dose of MPH or placebo. A follow-up assessment was conducted after a 6-month treatment with MPH. RESULTS: Compared with placebo, single MPH administration was associated with a more robust improvement in prefrontal cognitive performance, including achievements in the Hearts and Flowers executive function task and the visual continuous performance task. After 6 months of treatment, a 40% reduction in severity of ADHD symptoms was reported by parents on the Revised Conners Rating Scale. All subjects treated with MPH reported at least one side effect, but it did not necessitate discontinuation of treatment. MPH induced an increase in heart rate and blood pressure that was usually minor, but was clinically significant in two cases. No differences in response to MPH were observed between catechol-O-methyltransferase Met versus Val carriers. CONCLUSION: The use of MPH in children with VCFS appears to be effective and relatively safe. A comprehensive cardiovascular evaluation for children with VCFS before and during stimulant treatment is recommended.
Authors: Ole Jakob Storebø; Erica Ramstad; Helle B Krogh; Trine Danvad Nilausen; Maria Skoog; Mathilde Holmskov; Susanne Rosendal; Camilla Groth; Frederik L Magnusson; Carlos R Moreira-Maia; Donna Gillies; Kirsten Buch Rasmussen; Dorothy Gauci; Morris Zwi; Richard Kirubakaran; Bente Forsbøl; Erik Simonsen; Christian Gluud Journal: Cochrane Database Syst Rev Date: 2015-11-25
Authors: Maude Schneider; Martin Debbané; Anne S Bassett; Eva W C Chow; Wai Lun Alan Fung; Marianne van den Bree; Michael Owen; Kieran C Murphy; Maria Niarchou; Wendy R Kates; Kevin M Antshel; Wanda Fremont; Donna M McDonald-McGinn; Raquel E Gur; Elaine H Zackai; Jacob Vorstman; Sasja N Duijff; Petra W J Klaassen; Ann Swillen; Doron Gothelf; Tamar Green; Abraham Weizman; Therese Van Amelsvoort; Laurens Evers; Erik Boot; Vandana Shashi; Stephen R Hooper; Carrie E Bearden; Maria Jalbrzikowski; Marco Armando; Stefano Vicari; Declan G Murphy; Opal Ousley; Linda E Campbell; Tony J Simon; Stephan Eliez Journal: Am J Psychiatry Date: 2014-06 Impact factor: 18.112
Authors: Ole Jakob Storebø; Nadia Pedersen; Erica Ramstad; Maja Lærke Kielsholm; Signe Sofie Nielsen; Helle B Krogh; Carlos R Moreira-Maia; Frederik L Magnusson; Mathilde Holmskov; Trine Gerner; Maria Skoog; Susanne Rosendal; Camilla Groth; Donna Gillies; Kirsten Buch Rasmussen; Dorothy Gauci; Morris Zwi; Richard Kirubakaran; Sasja J Håkonsen; Lise Aagaard; Erik Simonsen; Christian Gluud Journal: Cochrane Database Syst Rev Date: 2018-05-09