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Right arrow Neurology & Psychiatry

PEDIATRICS Vol. 100 No. 6 December 1997, p. e6

ELECTRONIC ARTICLE:
Methylphenidate Versus Dexamphetamine in Children With Attention Deficit Hyperactivity Disorder: A Double-blind, Crossover Trial

Received May 1, 1997; accepted Jul 14, 1997.

Daryl Efron, Frederick Jarman, and Melinda Barker

From the Centre for Community Child Health and Ambulatory Paediatrics, Royal Children's Hospital, Melbourne, Australia.

Objective.  To compare methylphenidate (MPH) and dexamphetamine (DEX) in a sample of children with attention deficit hyperactivity disorder (ADHD).

Method.  A total of 125 children with ADHD received both MPH (0.3 mg/kg twice daily) and DEX (0.15 mg/kg twice daily) for 2 weeks a double-blind, crossover study. Outcome measures were Conners' Parent Rating Scale-Revised, Conners' Teacher Rating Scale-Revised, a Parent Global Perceptions questionnaire, the Continuous Performance Test, and the Barkley Side Effects Rating Scale.

Results.  There were significant group mean improvements from baseline score on all measures for both stimulants. On the Conners' Teacher Rating Scale-Revised, response was greater on MPH than DEX on the conduct problems and hyperactivity factors, as well as on the hyperactivity index. On the Conners' Parent Rating Scale-Revised, anxiety was the only factor to differ significantly, in favor of MPH. Parents rated 73% of subjects as globally improved on MPH and 69% improved on DEX, compared with baseline. Overall, 46% of parents chose MPH as the preferred drug, compared with 37% who chose DEX. On the Continuous Performance Test, there was no difference in the number of correct responses or errors between the two drugs.

Conclusions.  Most children with ADHD improve significantly on both MPH and DEX. There was a slight advantage to MPH on most measures.

Key words: attention deficit hyperactivity disorder, stimulant medication, methylphenidate, dexamphetamine.