OBJECTIVE: The therapeutic effect of methylphenidate (MPH) in treating attention-deficit/hyperactivity disorder (ADHD) has been related to the alpha-2A adrenergic receptor (ADRA2A) gene -1291C/G single nucleotide polymorphism (SNP). We investigated the effect of MPH in treating Taiwanese children and adolescent with ADHD and its relation to the ADRA2A gene -1291C/G SNP. METHODS: The subjects with DSM-IV ADHD diagnosis underwent a titration period to find out the dose of MPH for maintenance treatment. After 4 weeks maintenance treatment, the effect of MPH was evaluated by the Swanson, Nolan and Pelham version IV total scores. The subjects with more than 25% score reduction were referred to responders and those with ≥50% improvement were considered as better responders. The -1291C/G variant of the ADRA2A gene was identified by DNA sequencing and what relevance it has to the MPH response was examined by binary logistic regression analysis. RESULTS: Of the 59 subjects, 44 (74.6%) were responsive to MPH treatment and the responsiveness was not shown to be associated with the ADRA2A gene -1291C/G SNP. As the responsive subjects were categorized as moderate responders and better responders and subjected to statistical analysis, the GG homozygotes showed a greater chance to have a better response to MPH treatment than CC homozygotes (p=0.02), with an odds ratio of 32.14 (95% CI=1.64–627.80). CONCLUSION: The ADRA2A gene -1291C/G SNP is associated with the efficacy of MPH for the treatment of ADHD in Taiwanese children and adolescents. The responsive subjects bearing homozygous -1291G allele are more likely to have a better response to MPH treatment.
Adolescent* ; Alleles ; Child* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Homozygote ; Humans ; Logistic Models ; Methylphenidate* ; Odds Ratio ; Pharmacogenetics ; Polymorphism, Single Nucleotide* ; Receptors, Adrenergic, alpha-2* ; Sequence Analysis, DNA

Background: The rise in substance-use-related problems among Malaysian adolescents called for a study to assess the efficacy of an anti-drug educational program to improve the knowledge, attitudeand perception (KAP) of Malaysian students regarding substance use. Methods: This study involved 573 students from four Malaysian Chinese schools in Malacca. Each student filled out a Likert-scale mandarin translated questionnaire (KAP-C) on substance use ( Pre-test). Following an educational program on substance use, the KAP-C questionnaire was given again to the students, immediately following the program (PT 1), and after a month (PT 2) and two months (PT3) of the programme. Results: The students showed improvement in knowledge of the types of substance use in PT 1 (p<0.001), PT 2 (p<0.001) and PT 3 (p<0.001). The study also showed persistent changes in their attitude towards drug treatment strategies at two months following the program (p < 0.05). Changes were also noted in their attitudestowards harm reduction strategies. Perceptions towards the substance-related problems changed following the module (p=0.001), and remained even after two months (p<0.001). Conclusion: This module effectively changed the KAP of students on substance use.