Differential effectiveness of methylphenidate and Adderall (R) in school-age youths with attention deficit hyperactivity disorder

Objective: To compare the effectiveness of a single dose of Adderall(R) (q. d.) with that of 2 daily doses of methylphenidate (b.i.d.; MPH) as a treatm ent for attention-deficit/hyperactivity disorder (ADHD) in youths ranging i n age from 5 to 17 years. Forty-two youths treated with MPH were compared w ith 42 youths treated with Adderall(R). Subjects were matched for age, sex, and DSM-IV diagnostic subtype. Method: Youths were assigned to the Adderal l(R) or MPH condition by their prescribing physician. All youths were evalu ated under 5 conditions, including baseline, placebo, 5 mg, 10 mg, and 15 m g. The best dose was assigned prior to breaking the medication blind and wa s assigned by the consensus of the psychologist and psychiatrist Subjective ratings by both teachers and parents were examined for dosage level effect s and medication type effects. Results: Best dose was always superior to ba seline and placebo conditions. No differences between MPH and Adderall(R) w ere observed on either teacher or parent ratings of behavior. Conclusions: Both MPH and Adderall(R) have been shown to be effective treatments for chi ldren with ADHD. Both medications appear to improve teachers' and parents' ratings of behavior. Single-dose treatments of Adderall(R) appear to be as effective as 2 daily doses of MPH and therefore increase the possibility of managing treatment without involving the school in medication administrati on. In addition, youths who have previously been unsuccessfully treated wit h MPH because of adverse side effects or poor response may be successfully treated with Adderall(R).