Psychostimulants in preschool children with attention-deficit/hyperactivity disorder: Clinical evidence from a developmental disorders institution

Objective: To examine psychostimulant response in preschool children with a ttention-deficit/hyperactivity disorder (ADHD) in an outpatient child psych iatry clinic (housed within a developmental disorders institution) over 3, 12, and 24 months of treatment. Method: A systematic retrospective chart re view was conducted for 27 preschool children with ADHD who were started on psychostimulants between the ages of 3 and 5 years, inclusive. Two child an d adolescent psychiatrists reviewed each chart independently, using the Cli nical Global Impressions (CGI) scale to rate the severity of illness and gl obal improvement and the Side Effects Rating Form to rate side effects. Res ults: Over 24 months, psychostimulants were stopped in three children (11%) because of side effects and concomitant psychotropic medications were adde d in seven children (26%). The CGI severity-of-illness ratings showed a sig nificant effect of time over 3, 12, and 24 months of psychostimulant treatm ent (all p values < .0001). Rate of response was 74% at 3 months and 70% at 12 and 24 months. Side effects were mostly mild and occurred in 63% of the children at 3 months, 41% at 12 months, and 29% at 24 months. Conclusions: The findings suggest that preschool children with developmental disorders respond to psychostimulants but need close monitoring because of frequent s ide effects. Inasmuch as the study participants were recruited from a child psychiatry clinic housed within a developmental disorders institution and had a high rate of developmental disorders, the findings may not generalize to other preschool children with ADHD.