Evidence map›Paper›PMID 30566416›Full record

Trial reportJournal of clinical psychopharmacology

Does L-Methylfolate Supplement Methylphenidate Pharmacotherapy in Attention-Deficit/Hyperactivity Disorder?: Evidence of Lack of Benefit From a Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

Craig Surman, Atilla Ceranoglu, Carrie Vaudreuil, Brittany Albright, Mai Uchida, Amy Yule, Andrea Spencer, Heidi Boland, Rebecca Grossman, Lauren Rhodewalt and 2 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical psychopharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Craig SurmanFrom the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA.
Atilla Ceranoglu
Carrie Vaudreuil
Brittany Albright
Mai Uchida
Amy Yule
Andrea Spencer
Heidi Boland
Rebecca Grossman
Lauren Rhodewalt
Maura Fitzgerald
Joseph Biederman
Massachusetts General Hospital · US

Funding

AACAP Physician Scientist Program in Substance UseK12DA000357 · NIDA · AMERICAN ACADEMY-CHILD/ADOLESCENT PSYCH · PI Kevin M. Gray · 1998 to 2026
$29.1M
Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income ChildrenK23MH118478 · NIMH · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI SPENCER, ANDREA · 2018 to 2022
$696k
NIDA NIH HHS K12 DA000357NIMH NIH HHS K23 MH118478
6 · The paper itself

Abstract

PURPOSE/

backgroundInterventions for attention-deficit/hyperactivity disorder (ADHD) may be inadequate for some patients. There is evidence that supplementation with L-methylfolate augments antidepressant agent effects and thus might also augment ADHD treatment effects by a common catecholaminergic mechanism.

methodsForty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ADHD participated in a randomized, double-blind, placebo-controlled, 12-week trial of 15 mg of L-methylfolate in combination with osmotic-release oral system methylphenidate. Osmotic-release oral system methylphenidate was dose optimized over the first 6 weeks. We evaluated the effects on ADHD symptoms, self-report on the Behavior Rating Inventory of Executive Function of executive function, methylphenidate dosing, neuropsychological test measures, the Adult ADHD Self-report scale, emotional dysregulation, social adjustment, and work productivity, as well as moderating effects of body mass index, autoantibodies to folate receptors, and select genetic polymorphisms.

resultsL-Methylfolate was well tolerated, with no significant effect over placebo except improvement from abnormal measures on the mean adaptive dimension of the ASR scale (χ = 4.36, P = 0.04). Methylphenidate dosing was significantly higher in individuals on L-methylfolate over time (χ = 7.35, P = 0.007). Exploratory analyses suggested that variation in a guanosine triphosphate cyclohydrolase gene predicted association with higher doses of methylphenidate (P < 0.001).

conclusionsL-Methylfolate was associated with no change in efficacy on measures relevant to neuropsychiatric function in adults with ADHD, other than suggestion of reduced efficacy of methylphenidate. Further investigation would be required to confirm this effect and its mechanism and the genotype prediction of effects on dosing.

Indexed as

Administration, OralAdultAttention Deficit Disorder with HyperactivityAutoantibodiesCentral Nervous System StimulantsDelayed-Action PreparationsDietary SupplementsDiet TherapyDopamine Uptake InhibitorsDose-Response Relationship, DrugDouble-Blind MethodDrug Therapy, CombinationExecutive FunctionFemaleFolate Receptor 1GTP Cyclohydrolase5-methyltetrahydrofolateAutoantibodiesCentral Nervous System StimulantsDelayed-Action PreparationsDopamine Uptake InhibitorsFolate Receptor 1FOLR1 protein, humanGTP CyclohydrolaseMethylphenidateTetrahydrofolates

Identifiers

PMID30566416
PMCPMC6750952
OpenAlexW2905173910

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.