Medication treatment strategies in the MTA study

Relevance to clinicians and researchers

Laurence L. Greenhill, Howard B. Abikoff, L. Eugene Arnold, Dennis P. Cantwell, C. Keith Conners, Glen Elliott, Lily Hechtman, Stephen P. Hinshaw, Betsy Hoza, Peter S. Jensen, John S. March, Jeffrey Newcorn, William E. Pelham, Joanne B. Severe, James M. Swanson, Ben Vitiello, Karen Wells

Research output: Contribution to journalArticle

219 Citations (Scopus)

Abstract

Objective: Clinicians have difficulty applying drug research findings to clinical practice, because research protocols use methods different from those used in daily office practice settings. Method: To design a medication protocol for a multisite clinical trial involving 576 children with attention-deficit hyperactivity disorder (ADHD) while maintaining relevance to clinical practice, investigators from the NIMH Collaborative Multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA study) developed novel medication strategies. These were designed to work either in a monomodal or multimodal format and to ensure standard approaches are used across diverse sites. Each child randomized to medication (projected N = 288) is individually titrated to his or her 'best' methylphenidate dose and has individual ADHD symptoms monitored. Decision rules were developed to guide 'best dose' selection, dose changes, medication changes, the management of side effects, and integration with psychosocial treatments. Conclusions: The MTA study uses a controlled method to standardize the identification of each child's 'best' methylphenidate dose in a national, multisite cooperative treatment program. Although the titration protocol is complex, the study's individual dosing approach and algorithms for openly managing ADHD children's medication over time will be of interest to clinicians in office practice.

Original languageEnglish (US)
Pages (from-to)1304-1313
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume35
Issue number10
StatePublished - Oct 1996
Externally publishedYes

Fingerprint

Pemetrexed
Attention Deficit Disorder with Hyperactivity
Research Personnel
Methylphenidate
National Institute of Mental Health (U.S.)
Therapeutics
Combined Modality Therapy
Research
Clinical Trials
Pharmaceutical Preparations

Keywords

  • attention-deficit hyperactivity disorder
  • dextroamphetamine
  • imipramine
  • methylphenidate
  • multisite trial
  • pemoline

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

Greenhill, L. L., Abikoff, H. B., Arnold, L. E., Cantwell, D. P., Conners, C. K., Elliott, G., ... Wells, K. (1996). Medication treatment strategies in the MTA study: Relevance to clinicians and researchers. Journal of the American Academy of Child and Adolescent Psychiatry, 35(10), 1304-1313.

Medication treatment strategies in the MTA study : Relevance to clinicians and researchers. / Greenhill, Laurence L.; Abikoff, Howard B.; Arnold, L. Eugene; Cantwell, Dennis P.; Conners, C. Keith; Elliott, Glen; Hechtman, Lily; Hinshaw, Stephen P.; Hoza, Betsy; Jensen, Peter S.; March, John S.; Newcorn, Jeffrey; Pelham, William E.; Severe, Joanne B.; Swanson, James M.; Vitiello, Ben; Wells, Karen.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 35, No. 10, 10.1996, p. 1304-1313.

Research output: Contribution to journalArticle

Greenhill, LL, Abikoff, HB, Arnold, LE, Cantwell, DP, Conners, CK, Elliott, G, Hechtman, L, Hinshaw, SP, Hoza, B, Jensen, PS, March, JS, Newcorn, J, Pelham, WE, Severe, JB, Swanson, JM, Vitiello, B & Wells, K 1996, 'Medication treatment strategies in the MTA study: Relevance to clinicians and researchers', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 35, no. 10, pp. 1304-1313.
Greenhill LL, Abikoff HB, Arnold LE, Cantwell DP, Conners CK, Elliott G et al. Medication treatment strategies in the MTA study: Relevance to clinicians and researchers. Journal of the American Academy of Child and Adolescent Psychiatry. 1996 Oct;35(10):1304-1313.
Greenhill, Laurence L. ; Abikoff, Howard B. ; Arnold, L. Eugene ; Cantwell, Dennis P. ; Conners, C. Keith ; Elliott, Glen ; Hechtman, Lily ; Hinshaw, Stephen P. ; Hoza, Betsy ; Jensen, Peter S. ; March, John S. ; Newcorn, Jeffrey ; Pelham, William E. ; Severe, Joanne B. ; Swanson, James M. ; Vitiello, Ben ; Wells, Karen. / Medication treatment strategies in the MTA study : Relevance to clinicians and researchers. In: Journal of the American Academy of Child and Adolescent Psychiatry. 1996 ; Vol. 35, No. 10. pp. 1304-1313.
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