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ADD/ADHD Online Information
October 20th 2003
An independant press release from AACAP
AACAP: Stimulants More Effective than Atomoxetine for Once-Daily Treatment of Attention Deficit/Hyperactivity Disorder
(October 17, 2003) -- Older children treated with methylphenidate (Ritalin)
for attention deficit hyperactivity disorder (ADHD) may be adversely affected
by drug holidays, according to research presented at the 50th Anniversary
Meeting of the American Academy of Child and Adolescent Psychology.
"One of the most interesting findings in this study is that the kids who took
drug holidays seemed to do less well in terms of their functioning at home as
rated by parents than the kids who did not take the drug holidays, " said
Stephen V. Faraone, PhD, lead researcher, Massachusetts General Hospital, Boston,
Massachusetts. "To the contrary we found no decrease in efficacy according to
teacher ratings and that's consistent with the fact that the drug holidays
tend to be taken at home."
For this study, investigators enrolled children between the ages of 6 and 13
years who were diagnosed with ADHD. The children were being treated with
Ritalin (methylphenidate) as part of a multicenter, open-label, 12-month study.
Drug holidays were assessed according to self-reported proportion of days
that medication was not taken. Predictors of non-compliance with treatment were
baseline demographic and clinical variable such as tic history, dose, ADHD
subtype and Swanson, Nolan and Pelham Revision IV (SNAP-IV) questionnaire and IOWA
Conners rating scale, parent/teacher efficacy ratings, and parent
Researchers found that drug holidays were substantial and were predicted by
baseline characteristics such as older age (P=0.02), inattentive subtype ADHD
(P=0.0024), and fewer hyperactivity/impulsivity and oppositional defiant
disorder symptoms (P<0.05). Lower methylphenidate dose and minority ethnic status
also were predictive characteristics (P=0.03 and P=0.004, respectively).
The researchers also noted that drug holidays during follow-up were
associated with poorer efficacy at home (P=0.0016) but not at school (P=0.58).
In light of the findings, they recommended caution when considering drug
holidays for older ADHD children taking Ritalin.
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