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Short Trial Useful For Parents Deciding About Methylphenidate For Their Children WESTPORT, Dec 28 (Reuters Health) - A short placebo-controlled trial of methylphenidate, rather than an open prescription, can aid parents in determining whether the drug is appropriate for their children with attention-deficit/hyperactivity disorder (ADHD). "Regardless of the outcome, it was important for families to complete the [methylphenidate placebo-controlled trial] to understand, for their own child, the effect of methylphenidate on the child's behavior and the presence of any side effects," Dr. Carol S. Camfield and colleagues at Dalhousie University Medical School, in Halifax, Nova Scotia, explain in the December issue of Archives of Pediatric and Adolescent Medicine. The team used an "N of 1" trial of methylphenidate to help 50 families determine whether the drug was the correct treatment choice for a child with ADHD. Each family received three bottles of capsules that contained, in random order, placebo, 0.3 mg/kg methylphenidate or 0.6 mg/kg methylphenidate. Children received one capsule at 8 AM and another at noon each day during the 3-week trial. Nearly two thirds of the children in the study responded to methylphenidate, based on questionnaires completed by parents and teachers. Twenty-six percent of the children continued to use the drug for 2 to 12 months after the trial ended, and 47% continued use for more than 12 months after the end of the study. Children who continued to use methylphenidate showed significant declines in aggression and discipline problems compared with nonusers, according to the report. All of the families said that the trial helped them determine whether continuing methylphenidate was the correct treatment choice for their children, Dr. Camfield and colleagues say. In fact, 68% said that they used the trial results exclusively in making this decision. "We found the [methylphenidate placebo-controlled trial] to be helpful, practical and definitive for families of children with attention-deficit/hyperactivity disorder to making a decision about medication use," the Canadian team reports. The researchers consider it feasible to offer a controlled trial in community-based practice. "Our method of preparation for blinded medication or placebo can be carried out by any willing community pharmacist," the team writes. "Given the current concern about overuse of methylphenidate, this technique ensures the practitioner and family that the drug has a desirable effect without serious side effects." Arch Pediatr Adolesc Med 1999;153:1292-1296. |