Testing tic suppression: comparing the effects of dexmethylphenidate to no medication in children and adolescents with attention-deficit/hyperactivity disorder and Tourette's disorder.

Abstract

OBJECTIVE:

The aim of this study was to conduct a pilot study testing whether single-dose, immediate-release dexmethylphenidate (dMPH) can facilitate tic suppression in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and Tourette's disorder (TD) or chronic tic disorders. The primary hypothesis is that dMPH will improve behaviorally reinforced tic suppression in a standard tic suppression paradigm (TSP).

METHODS:

Ten children with ADHD and TD were given dMPH on one visit and no medication on another, using a random crossover design. On both days, following a baseline period, subjects were reinforced for suppressing tics using a standard TSP.

RESULTS:

Thirteen subjects were enrolled; 10 subjects (mean age 12.7 +/- 2.6; 90% male) completed all study procedures. Relative to the no-medication condition, tics were reduced when children were given a single dose of dMPH. Behavioral reinforcement of tic suppression resulted in lower rates of tics compared to baseline, but dMPH did not enhance this suppression.

CONCLUSION:

Preliminary results indicate replication of prior studies of behavioral tic suppression in youths with TD and without ADHD. In addition, our findings indicate tic reduction (and not tic exacerbation) with acute dMPH challenge in children and adolescents with ADHD and TD.

• Authors: Gholson J Lyon, Stephanie M Samar, Christine Conelea, Marcel R Trujillo, Christina M Lipinski, Christopher C Bauer, Bryan C Brandt, Joshua J Kemp, Zoe E Lawrence, Jonathan Howard, F Xavier Castellanos, Douglas Woods, Barbara J Coffey
• Journal: Journal of child and adolescent psychopharmacology (J Child Adolesc Psychopharmacol) Vol. 20 Issue 4 Pg. 283-9 (Aug 2010) ISSN: 1557-8992 [Electronic] United States
• PMID: 20807066 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Central Nervous System Stimulants
• Dexmethylphenidate Hydrochloride
• Methylphenidate

Topics

• Adolescent
• Attention Deficit Disorder with Hyperactivity (drug therapy, physiopathology, psychology)
• Central Nervous System Stimulants (pharmacology)
• Child
• Combined Modality Therapy
• Cross-Over Studies
• Dexmethylphenidate Hydrochloride
• Female
• Humans
• Male
• Methylphenidate (pharmacology)
• Pilot Projects
• Reinforcement, Psychology
• Tics (drug therapy, etiology, psychology)
• Tourette Syndrome (drug therapy, physiopathology, psychology)