OBJECTIVE: The primary aim of this study was to investigate the acute impact of methylphenidate (MPH) on sleep parameters in attention-deficit/hyperactivity disorder (ADHD) children. The second aim was to investigate the different effects of intermediate- and longacting MPH on sleep parameters. The third aim was to test the different effects of dose and age on sleep parameters. METHODS: Ninety-three ADHD children were enrolled and randomized to two different MPH preparations. Baseline and daily sleep diaries were evaluated for four weeks after taking medication. Weekday and weekend bedtimes, wake-up times, sleep latencies and total sleep times were compared by weeks. RESULTS: After taking MPH, there was a significant delay in bedtimes and a significant reduction of total sleep time (TST) both on weekdays and at weekends. There was also a significant delay in wake-up time on weekdays. However, the difference was applied to younger age group children only. There was no difference in changes of TST between metadate-CD and OROS-MPH. There also was no difference in changes of TST with different doses of MPH. CONCLUSION: MPH had negative impacts on sleep among young ADHD children, but different preparations and doses did not affect the result.
Child ; Humans ; Methylphenidate ; Phenazines

Several medications are reported to be effective in treatment of encopresis. However, mechanisms of action related to these drugs are not known. We report a patient with ADHD and encopresis whose encopretic signs have disappeared with long acting methylphenidate while they have not changed with atomoxetine.
Encopresis* ; Humans ; Methylphenidate* ; Atomoxetine Hydrochloride

OBJECTIVE: The aim of this study was to determine changes in behaviour among patients with attention deficit/hyperactivity disorder (ADHD) by different informants during treatment in the clinical setting. METHODS: Seventy-nine patients with ADHD were recruited. They completed 12-months of treatment with oral short-acting methylphenidate, two-to-three times per day, at a dose of 0.3-1.0 mg/kg. Among the 79 patients (mean age, 9.1+/-1.9 years), 39 were classified as the ADHD-C/H type (hyperactive-impulsive type and combined type) and 40 as the ADHD-I type (inattentive type). At baseline, and after 12 months, their behaviour was assessed using the Child Behaviour Checklist (CBCL), Teacher's Report Form (TRF), ADHD Rating Scale (ADHD-RS), and Clinical Global Impression-Severity (CGI-S). RESULTS: Patients classified as the ADHD-C/H type had higher scores on three CBCL subscales, on the ADHD-RS and CGI-S compared to the ADHD-I type patients. After 12-months of treatment, for all patients, there were significant improvements in the four subscales of the TRF as well as the ADHD-RS and CGI-S scores, but not on the CBCL. In addition, the patients with the ADHD-C/H type had greater improvements on the four subscales of the TRF after treatment. However, there were no differences noted on the CBCL, ADHD-RS and CGI-S. CONCLUSION: The results of this study showed that during treatment, in the clinical setting, there are different assessments of behaviour symptoms, associated with ADHD, reported by different informants. Assessments of behaviour profiles from multiple informants are crucial for establishing a fuller picture of patients with ADHD.
Checklist ; Child ; Humans ; Methylphenidate ; Parents

OBJECTIVE: This study was aimed to determine effectiveness and tolerability of Osmotic-controlled Release Oral delivery (OROS) methylphenidate (MPH) and its optimal dose administered openly over a period of up to 12 weeks in drug naive Korean children with ADHD. METHODS: Subjects (n=143), ages 6 to 18-years, with a clinical diagnosis of any subtype of ADHD were recruited from 7 medical centers in Korea. An individualized dose of OROS-MPH was determined for each subject depending on the response criteria. The subjects were assessed with several symptom rating scales in week 1, 3, 6, 9 and 12. RESULTS: 77 of 116 subjects (66.4%) achieved the criteria for response and the average of optimal daily dose for response was to 30.05+/-12.52 mg per day (0.90+/-0.31 mg/kg/d) at the end of the study. Optimal dose was not significantly different between ADHD subtypes, whereas, significant higher dose was needed in older aged groups than younger groups. The average of optimal daily dose for response for the subjects aged above 12 years old was 46.38+/-15.52 per day (0.81+/-0.28 mg/kg/d) compared to younger groups (p<0.01). No serious adverse effects were reported and the dose did not have a significant effect on adverse effects. CONCLUSION: Optimal mean dose of OROS-MPH was significantly different by age groups. Higher dose was needed in older aged groups than younger groups. Effectiveness and tolerability of OROS-MPH in symptoms of ADHD is sustained for up to 12 weeks.
Aged ; Child ; Humans ; Korea ; Methylphenidate ; Weights and Measures

Attention-deficit/hyperactivity disorder (ADHD) is one of the common psychiatric problems in childhood. The symptoms of ADHD tend to last for adulthood and the patients suffer from various comorbid problems and functional impairments. Methylphenidate (MPH) is the first choice of pharmacotherapy for ADHD and many researches have demonstrated its efficacy. We reviewed the clinical trials for efficacy of MPH focusing on Osmotic-Controlled Release Oral delivery System Methylphenidate (OROS MPH). It was identified that MPH improved core symptom of ADHD, peer relationship and health related quality of life and might improve various aspects of cognitive function. It was proved that the efficacy of OROS MPH was better than placebo and comparable to immediate release MPH (IR MPH) dosed three times daily in various studies. Especially, parent's preference of OROS MPH was better than IR MPH. The efficacy of MPH for academic achievement was equivocal. Long-term efficacy of OROS MPH was also inconclusive and further study is necessary.
Achievement ; Humans ; Methylphenidate ; Phenazines ; Quality of Life

Attention-deficit/hyperactivity disorder (ADHD) is one of the common psychiatric problems in childhood. The symptoms of ADHD tend to last for adulthood and the patients suffer from various comorbid problems and functional impairments. Methylphenidate (MPH) is the first choice of pharmacotherapy for ADHD and many researches have demonstrated its efficacy. We reviewed the clinical trials for efficacy of MPH focusing on Osmotic-Controlled Release Oral delivery System Methylphenidate (OROS MPH). It was identified that MPH improved core symptom of ADHD, peer relationship and health related quality of life and might improve various aspects of cognitive function. It was proved that the efficacy of OROS MPH was better than placebo and comparable to immediate release MPH (IR MPH) dosed three times daily in various studies. Especially, parent's preference of OROS MPH was better than IR MPH. The efficacy of MPH for academic achievement was equivocal. Long-term efficacy of OROS MPH was also inconclusive and further study is necessary.
Achievement ; Humans ; Methylphenidate ; Phenazines ; Quality of Life

The effectivenss of intravenous Ritalin (10 mg vs. 20 mg) and nasal instillation of diethyl ether (2 cc) for the treatment of hiccup in 38 patients during and immediately following anesthesia. Ritalin, regardless of the dosage employed, was more effective than ether. Nausea and retching were more prevalent among patients treated with Ritalin, however, than with ether.
Anesthesia* ; Ether ; Hiccup* ; Humans ; Methylphenidate ; Nausea

OBJECTIVES: In the present study, we investigate the association between homozygosity of the 4-repeat allele (4/4) at the DRD4 and the response to the treatment with MPH in Korean children with ADHD. METHODS: The present study included 71 children with ADHD (8.231.78 years) from two children's psychiatric clinics in South Korea. All drug-naive children with ADHD were treated with MPH for about 8 weeks. The subjects who showed improvement of over 50% compared with the baseline ARS score after 8 weeks of treatment were termed as the 'good response' group. The subjects who showed an improvement of less than 50% were considered as the 'poor response' group. After genotyping for DRD4 were performed, we investigated correlation between homozygosity for 4-repeat allele at DRD4 and the response to MPH treatment. RESULTS: We found that while 79.5% (31/39) of the subjects with homozygosity of 4-repeat allele at DRD4 showed good response to MPH treatment, 68.8% (22/32) of the subjects without homozygosity of 4-repeat allele at DRD4 showed poor response to MPH treatment according to ARS scores assessed by their parents (chi2=16.762, df=1, p<0.01). We also found that while 61.5% (24/39) of the subjects with homozygosity of4-repeat allele at DRD4 showed good response to MPH treatment, 87.5% (28/32) of the subjects without homozygosity of the 4-repeat allele at DRD4 showed poor response to MPH treatment according to ARS scores assessed by their teachers (chi2=17.698, df=1, p<0.01). CONCLUSION: Our findings support an association between the homozygosity of 4-repeat allele and a good response to MPH in ADHD of Koreans.
Alleles ; Child* ; Dopamine* ; Humans ; Korea ; Methylphenidate* ; Parents ; Receptors, Dopamine D4*

OBJECTIVE: This study was designed to examine whether the methylphenidate(MPD) might have an effect on the negative symptoms in schizophrenic patients. METHOD: We administered MPD to 22 schizophrenic patients who had been taking haloperidol(HPD) by double-blind trial for 6 weeks. The scores of PANSS(Positive and Negative symptom Scale) and AIMS(Abnormal Involuntary Movement Scale) and other side effects were compared between the group of MP and HPD coadmistration and that of HPD at baseline and 2, 4 and 6 weeks after. All patients were followed up for the clinical changes 1 year after the study. RESULT: There were not significant differences between the group of MP and HPD coadministration and that of HPD in PANSS, AIMS and other side effects. The clinical scores were not changed in the group of MP and HPD coadministration as well as in that of HPD. CONCLUSION: These results suggest that MP would not have an effect on the negative symptoms in schizophrenic patients.
Dyskinesias ; Follow-Up Studies* ; Haloperidol* ; Humans ; Methylphenidate* ; Schizophrenia

We review the effect of methylphenidate, focusing on Osmotic-controlled Release Oral delivery System (OROS) methylphenidate, on cardiovascular system, appetite and growth, sleep, tic, epilepsy, psychiatric and rare adverse events. Although OROS methylphenidate has side effects including increased heart rate or blood pressure, decreased appetite, delayed sleep onset, emergence or aggravation of tics, withdrawal or changes in mood, these effects appeared to be minimal in impact or difficult to distinguish from risk to untreated population and tended to be improved by dose adjustment or drug discontinuation. However, in subjects with underlying cardiac problems, uncontrolled epilepsy, previous psychotic episode, clinicians should pay attention and balance the risk and benefit.
Appetite ; Blood Pressure ; Cardiovascular System ; Epilepsy ; Heart Rate ; Methylphenidate ; Tics