Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial

Laurence L. Greenhill; James M. Swanson; Benedetto Vitiello; Mark Davies; Walter Clevenger; Min Wu; L. Eugene Arnold; Howard B. Abikoff; Oscar G. Bukstein; C. Keith Conners; Glen R. Elliott; Lily Hechtman; Stephen P. Hinshaw; Betsy Hoza; Peter S. Jensen; Helena C. Kraemer; John S. March; Jeffrey H. Newcorn; Joanne B. Severe; Karen Wells; Timothy Wigal

doi:10.1097/00004583-200102000-00012

Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial

Laurence L. Greenhill, James M. Swanson, Benedetto Vitiello, Mark Davies, Walter Clevenger, Min Wu, L. Eugene Arnold, Howard B. Abikoff, Oscar G. Bukstein, C. Keith Conners, Glen R. Elliott, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, Helena C. Kraemer, John S. March, Jeffrey H. Newcorn, Joanne B. Severe, Karen WellsTimothy Wigal

Psychiatry and Psychology

Research output: Contribution to journal › Article › peer-review

197 Scopus citations

Abstract

Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F₃ = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F₃ = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.

Original language	English (US)
Pages (from-to)	180-187
Number of pages	8
Journal	Journal of the American Academy of Child and Adolescent Psychiatry
Volume	40
Issue number	2
DOIs	https://doi.org/10.1097/00004583-200102000-00012
State	Published - 2001

Keywords

Attention-deficit/hyperactivity disorder
Deportment
Impairment
Methylphenidate

ASJC Scopus subject areas

Developmental and Educational Psychology
Psychiatry and Mental health

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10.1097/00004583-200102000-00012

Cite this

Greenhill, L. L., Swanson, J. M., Vitiello, B., Davies, M., Clevenger, W., Wu, M., Arnold, L. E., Abikoff, H. B., Bukstein, O. G., Conners, C. K., Elliott, G. R., Hechtman, L., Hinshaw, S. P., Hoza, B., Jensen, P. S., Kraemer, H. C., March, J. S., Newcorn, J. H., Severe, J. B., ... Wigal, T. (2001). Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial. Journal of the American Academy of Child and Adolescent Psychiatry, 40(2), 180-187. https://doi.org/10.1097/00004583-200102000-00012

Greenhill, LL, Swanson, JM, Vitiello, B, Davies, M, Clevenger, W, Wu, M, Arnold, LE, Abikoff, HB, Bukstein, OG, Conners, CK, Elliott, GR, Hechtman, L, Hinshaw, SP, Hoza, B, Jensen, PS, Kraemer, HC, March, JS, Newcorn, JH, Severe, JB, Wells, K & Wigal, T 2001, 'Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 40, no. 2, pp. 180-187. https://doi.org/10.1097/00004583-200102000-00012

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title = "Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial",

abstract = "Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.",

keywords = "Attention-deficit/hyperactivity disorder, Deportment, Impairment, Methylphenidate",

author = "Greenhill, {Laurence L.} and Swanson, {James M.} and Benedetto Vitiello and Mark Davies and Walter Clevenger and Min Wu and Arnold, {L. Eugene} and Abikoff, {Howard B.} and Bukstein, {Oscar G.} and Conners, {C. Keith} and Elliott, {Glen R.} and Lily Hechtman and Hinshaw, {Stephen P.} and Betsy Hoza and Jensen, {Peter S.} and Kraemer, {Helena C.} and March, {John S.} and Newcorn, {Jeffrey H.} and Severe, {Joanne B.} and Karen Wells and Timothy Wigal",

note = "Funding Information: This work was supported by NIMH grant 5 UO1-MH50454-02 (Dr. Greenhill). ",

year = "2001",

doi = "10.1097/00004583-200102000-00012",

language = "English (US)",

volume = "40",

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T1 - Impairment and deportment responses to different methylphenidate doses in children with ADHD

T2 - The MTA titration trial

AU - Greenhill, Laurence L.

AU - Swanson, James M.

AU - Vitiello, Benedetto

AU - Davies, Mark

AU - Clevenger, Walter

AU - Wu, Min

AU - Arnold, L. Eugene

AU - Abikoff, Howard B.

AU - Bukstein, Oscar G.

AU - Conners, C. Keith

AU - Elliott, Glen R.

AU - Hechtman, Lily

AU - Hinshaw, Stephen P.

AU - Hoza, Betsy

AU - Jensen, Peter S.

AU - Kraemer, Helena C.

AU - March, John S.

AU - Newcorn, Jeffrey H.

AU - Severe, Joanne B.

AU - Wells, Karen

AU - Wigal, Timothy

N1 - Funding Information: This work was supported by NIMH grant 5 UO1-MH50454-02 (Dr. Greenhill).

PY - 2001

Y1 - 2001

N2 - Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.

AB - Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention- Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F3 = 100.6, n = 223, p = .0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F3 = 55.61, n = 253, p = .00001; effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily dose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.

KW - Attention-deficit/hyperactivity disorder

KW - Deportment

KW - Impairment

KW - Methylphenidate

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Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial

Abstract

Keywords

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