Medication OK for Preschoolers

Children under the age of six can benefit from low doses of stimulants, even if they experience greater side effects than older kids.

Preschoolers with ADHD can benefit from low doses of stimulant medications, although they may be more sensitive than older kids to side effects. That’s the finding of a National Institute of Mental Health (NIMH) study in which methylphenidate was given to 303 kids between three and five years of age. The FDA has not approved the use of methylphenidate for children under the age of six.

“The results show that preschoolers may benefit from low doses of medication when it is closely monitored, but the positive effects are less evident, and side effects are somewhat greater than previously reported in older children,” said NIMH director Thomas R. Insel, M.D.

“The best dose to reduce ADHD symptoms varied substantially, but the average [effective dose] across the whole group was as low as 14 mg per day,” said the study’s lead author, Laurence Greenhill, M.D., professor of clinical psychiatry at Columbia University and the New York State Psychiatric Institute in New York City. “Preschoolers may need only a low dose of methylphenidate initially, but they may need a higher dose later on to maintain the drug’s effectiveness.”

NIMH experts urge doctors to weigh the potential benefits of drug therapy against the risk of side effects, which include insomnia, loss of appetite, mood disturbances, and slowed growth rates. The study was published in the November 2006 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.