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Methylphenidate reduces ADHD symptoms in children with severe ADHD and intellectual disability

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Question: Are stimulants safe and effective for the treatment of children with attention deficit hyperactivity disorder (ADHD) and intellectual disability?

Patients: 122 children and adolescents (aged 7 years; 85% male) with ADHD (International Classification of Disease-10 diagnosis of hyperkinetic disorder) and intellectual disability (IQ 30–69). Recruitment was through clinical referrals and community screening (using the Special Education Needs Register and contact with special schools) with eligibility assessments carried out by study personnel based at the Institute of Psychiatry. Exclusions: current use of stimulant medication; use of neuroleptic medication in the past 6 months; or diagnosis of a dementing disorder, epilepsy with daily seizures, a psychotic disorder, bipolar disorder, severe obsessive compulsive disorder, substance use disorder or Tourette syndrome.

Setting: South-east England; randomisation June 2005–July 2008.

Intervention: Methylphenidate or placebo for 16 weeks. The treatment group was given immediate-release methylphenidate three times daily, with optimum doses individually titrated. The control group was given a …

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