Methylphenidate and comorbid anxiety disorder in children with both chronic multiple tic disorder and ADHD.

Abstract

OBJECTIVE:

To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD).

METHOD:

Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial with rating scales and laboratory measures.

RESULTS:

The +ANX group obtained more severe parent, teacher, and child ratings of anxiety and more severe parent ratings of depression, tics, oppositional defiant disorder (ODD), and peer aggression than the -ANX group. Treatment with short-term MPH-IR was associated with improvement in ADHD, ODD, and peer aggression in the +ANX group. When controlling for ODD severity, there were no apparent group differences in therapeutic response to MPH-IR in children ±ANX. There was little evidence that MPH-IR contributed to improvement in anxiety or depression symptoms in the +ANX group. There was some indication that children with comorbid anxiety may differentially experience greater increase in systolic blood pressure (0.5 mg/kg of MPH-IR > placebo).

CONCLUSION:

Findings suggest that the co-occurrence of diagnosed CMTD+ADHD+ANX represents a particularly troublesome clinical phenotype, at least in the home setting. Comorbid anxiety disorder was not associated with a less favorable response to MPH-IR in children with ADHD+CMTD, but replication with larger samples is warranted before firm conclusions can be drawn about potential group differences.

• Authors: Kenneth D Gadow, Edith E Nolan
• Journal: Journal of attention disorders (J Atten Disord) Vol. 15 Issue 3 Pg. 246-56 (Apr 2011) ISSN: 1557-1246 [Electronic] United States
• PMID: 20378921 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Central Nervous System Stimulants
• Methylphenidate

Topics

• Anxiety Disorders (complications, diagnosis, drug therapy)
• Attention Deficit Disorder with Hyperactivity (complications, diagnosis, drug therapy)
• Central Nervous System Stimulants (administration & dosage, therapeutic use)
• Child
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• Male
• Methylphenidate (administration & dosage, therapeutic use)
• Patient Selection
• Severity of Illness Index
• Tic Disorders (complications, diagnosis, drug therapy)
• Treatment Outcome