Benefits of Methylphenidate for Long-Term Attention Problems After Traumatic Brain Injury in Childhood: A Randomized, Double-Masked, Placebo-Controlled, Dose-Titration, Crossover Trial
Abstract
To characterize the benefits and optimal dose of long-acting methylphenidate for management of long-term attention problems after childhood traumatic brain injury (TBI). Phase 2, randomized, double-masked, placebo-controlled, dose-titration, crossover clinical trial. Outpatient, clinical research. Twenty-six children aged 6 to 17 years who were at least 6 months post-TBI and met criteria for attention-deficit hyperactivity disorder (ADHD) at the time of enrollment. Vanderbilt Rating Scale of attention problems, Pittsburgh Side Effects Rating Scale, and vital signs. Among the 26 participants randomized, 20 completed the trial. The mean ages at injury and enrollment were 6.3 and 11.5 years, respectively. Eight participants had a severe TBI. On an optimal dose of medication, greater reductions were found on the Vanderbilt Parent Rating Scale for the medicated condition than for placebo (P = .022, effect size = 0.59). The mean optimal dose of methylphenidate was 40.5 mg (1.00 mg/kg/day). Preinjury ADHD diagnosis status was not associated with a differential medication response. Methylphenidate was associated with weight loss (∼1 kg), increased systolic blood pressure (∼3- to 6-point increase), and mild reported changes in appetite....Continue Reading
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References
Traumatic brain injury in children and adolescents: psychiatric disorders in the second three months
Recommendations for the use of common outcome measures in pediatric traumatic brain injury research.
Clinical utility of the Vanderbilt ADHD diagnostic parent rating scale comorbidity screening scales.
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