Preschoolers with Three or More Disorders Show No Response to ADHD Medication Treatment

A study found that preschool age children with three or more coexisting disorders do not respond to treatments with the stimulant methylphenidate.

Thursday November 8th - 1:06pm

If a preschooler is diagnosed with three or more disorders, along with ADHD, they are not likely to respond to treatment with the stimulant methylphenidate, according to data from the Preschoolers with ADHD Treatment Study (PATS).

This study, funded by the National Institutes of Health’s National Institute of Mental Health (NIMH), is the most recent of seven published in the November 5, 2007 issue of “Journal of Child and Adolescent Psychopharmacology.” Previous reports from PATS showed low doses of methylphenidate were safe and effective in treating 3-5 year olds diagnosed with ADHD. However this study identifies individual characteristics that may affect how a child responds to treatment.

"This new data is an important step forward in bridging the gap between research results and clinical practice, bringing potentially valuable information to clinicians about ways to better customize treatments for their patients," said NIMH Director Thomas R. Insel, M.D. "It also identifies a group of young children who have significant and multiple problems, and for whom more research is needed to identify effective treatments."

Of the 165 children used in the study, 29 percent had no coexisting disorders, 42 percent had one coexisting disorder, 21 percent had two coexisting disorders and 9 percent had three or more coexisting disorders, with the most common coexisting disorders being oppositional defiant disorder, conduct disorder and anxiety disorders.

Researchers found that children with no or only one coexisting disorder were most likely to respond to methylphenidate, while those with two coexisting disorders were moderately likely to respond. Children with three or more coexisting disorders did not respond at all to the treatment. Demographics characteristics did not play a role in determining how the child would react to the treatment, however children with three or more coexisting disorders were more likely to live in a single-parent household.

"These results need to be replicated before they can be translated into practical recommendations," said Dr. Ghuman. "But they are a solid reminder that we need to find better treatments for children with multiple disorders and challenging circumstances."

For more information visit NIMH Research on Treatment for Attention Deficit Hyperactivity Disorder.

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