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Methylphenidate may improve symptoms but does not increase response compared with placebo in preschool children with ADHD

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 Q Is methylphenidate effective for preschool children with attention deficit/hyperactivity disorder?

METHODS

Embedded ImageDesign:

Crossover randomised controlled trial (titration phase) followed by parallel group randomised controlled trial (efficacy phase).

Embedded ImageAllocation:

Concealed.

Embedded ImageBlinding:

Double blind.

Embedded ImageFollow-up period:

Five weeks for titration phase and 4 weeks for efficacy phase.

Embedded ImageSetting:

Six academic sites, USA; enrolment February 2001 to April 2003.

Embedded ImagePatients:

Titration phase: 165 children aged 3–5.5 years with DSM-IV attention deficit/hyperactivity disorder (ADHD) of the predominantly hyperactive or combined subtypes (Revised Conners Parent and Teacher Rating Scale hyperactive-impulsive subscale T score of 65). Efficacy phase: 114 children completing the titration phase. Exclusions: previous stimulant treatment; intolerance to methylphenidate; Children’s Global Assessment Scale impairment score ⩾50; different primary caregiver over past 6 months; Full Scale IQ score equivalent of ⩽70 on the Differential Ability Scales; less than 2 days/week in school; adjustment disorder; psychosis; suicidal; other psychiatric disorder requiring medication; other medical condition; parental history of bipolar disorder; or cocaine or stimulant …

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