BEHAVIORAL, SITUATIONAL, AND TEMPORAL EFFECTS OF TREATMENT OF ADHD WITH METHYLPHENIDATE

Objective: To determine the behavioral, situational, and temporal effe cts of 4 months of methylphenidate (MPH) treatment for attention-defic it hyperactivity disorder (ADHD). Method: Ninety-one children with ADH D were randomly assigned to receive either MPH (titrated to a target d ose of 0.7 mg/kg twice a day) or a placebo. Treatment effects were inv estigated with measures sensitive to various behaviors (core and assoc iated symptoms), situations (home and school), time periods (morning a nd afternoon, after reaching the target dose, and after 4 months of tr eatment), and side effects. Results: MPH treatment improved symptoms o f ADHD and oppositional behavior at school, both in the morning and af ternoon, but not at home. Side effects (increase in physiological and affective symptoms, lack of weight gain) were significantly more frequ ent with MPH than with placebo treatment. Benefit was evident after ti tration, but the onset of some side effects was delayed. Side effects were reported by parents but not by teachers. Conclusions: Positive ef fects of MPH on behavior are evident in the classroom, but with MPH gi ven twice daily, parents do not report that MPH improves behavior at h ome. Greater impact on home behavior may require three times daily MPH and combined treatments.