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Transdermal methylphenidate more effective than placebo for treating ADHD

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QUESTION

Question:

How effective and safe is transdermal methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) compared with oral methyphenidate or placebo?

Patients:

282 children (6–12 years old) with ADHD who were either stimulant naive or responsive; who had IQ ⩾80, and ADHD Rating Scale-IV total score ⩾26. Main exclusions: comorbid psychiatric diagnosis (except oppositional defiant disorder); tic disorder; seizures in past 2 years; concurrent illness potentially compromising study safety; use of certain medications including antidepressants, antipsychotics, and anxiolytics in the 30 days prior to study entry. Children who did not respond (ie, <25% reduction in symptoms) to the 5-week dose optimisation phase, or who had an unacceptable safety profile, were withdrawn from the study.

Setting:

Community-based study in the USA; performed August 2004 to February 2005.

Intervention:

Daily receipt of a patch and a capsule in one of the following three combinations: methylphenidate transdermal system (MTS) plus placebo capsule, osmotic-release oral system methylphenidate (OROSM) plus placebo patch, or placebo capsule plus placebo patch. …

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