Stimulant treatment in young boys with symptoms suggesting childhood mania: A report from a longitudinal study

This study used data from a completed longitudinal study to examine the eff ects of methylphenidate on 6-12-year-old boys presumably at risk for bipola r disorder. Of 75 boys referred, diagnosed with hyperkinetic reaction of ch ildhood (minimal brain dysfunction), treated clinically with methylphenidat e, and followed as young adults, 23% (the maximorbid or MAX group) had chil dhood symptoms of irritability and emulated DSM-IV diagnoses of attention d eficit hyperactivity disorder (ADHD), plus oppositional defiant or conduct disorder (ODD/CD) and anxiety or depression or both. The remaining boys (th e minimorbid or MIN group) had fewer symptoms and disorders. MAX and MIN gr oups did not differ in rated response to methylphenidate, duration of treat ment, clinically determined maintenance doses, concurrent or subsequent tre atment with other medications, or other aspects of medication experience, A t ages 21-23, individuals with bipolar-related lifetime diagnoses (adult ma nia, hypomania, or cyclothymia) did not differ from those without bipolar-r elated diagnoses in any aspect of early methylphenidate treatment history, These findings indicate that ADHD boys with symptoms suggesting childhood m ania do not respond differently to methylphenidate than boys without such s ymptoms, and there is no evidence here that methylphenidate precipitates yo ung adult bipolar disorders in susceptible individuals.