Evidence map›Paper›PMID 38280943›Full record

Trial reportPaediatric drugs2024

Improving Methylphenidate Titration in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): A Randomized Controlled Trial Using Placebo-Controlled Titration Implemented in Clinical Practice.

Karen Vertessen, Marjolein Luman, Pierre Bet, Catharina E Bergwerff, Marco Bottelier, Reino Stoffelsen, James M Swanson, Annemiek Wisse, Jos Twisk, Jaap Oosterlaan

Open access · greenAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Paediatric drugs, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 24% 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, 3 citations in OpenAlex.

  1. Trial
  2. Review
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

10 authors at 6 institutions in 3 countries.

Karen VertessenVrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. k.vertessen@vu.nl.ORCID http://orcid.org/0000-0001-8601-6406
Marjolein LumanVrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-1539-2831
Pierre BetDepartment of Clinical Pharmacology and Pharmacy, Amsterdam UMC, VU Medical Center, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-6735-7379
Catharina E BergwerffInstitute of Education and Child Studies, Leiden University, Leiden, The Netherlands.ORCID http://orcid.org/0000-0002-5837-3497
Marco BottelierChild Study Center Accare, UMC Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0003-1428-4123
Reino StoffelsenLevvel Specialists in Youth and Family Care, Amsterdam, The Netherlands.
James M SwansonDepartment of Pediatrics, University of California, Irvine, USA.
Annemiek WisseYouz, Center for Youth Mental Healthcare, Velsen-Noord, The Netherlands.
Jos TwiskDepartment of Epidemiology and Biostatistics, VU Medical Center, Amsterdam, Amsterdam, The Netherlands.
Jaap OosterlaanVrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0218-5630
Amsterdam UMC Location Vrije Universiteit Amsterdam · NLVrije Universiteit Amsterdam · NLAccare · NLEmma Kinderziekenhuis · NLLeiden University · NLUniversity of California, Irvine · US

Funding

Innovatiefonds Zorgverzekeraars p3119
6 · The paper itself

Abstract

BACKGROUND AND

objectivesConcerns exist regarding the rising use of methylphenidate. A double-blind, placebo-controlled methylphenidate titration (PCT) for children with attention-deficit/hyperactivity disorder (ADHD) has shown potential to improve titration (i.e., detection of placebo responders and larger ADHD symptom improvement) in experimental settings. This study aims to determine if these advantages can be transferred to clinical settings.

methodChildren (aged 5-13 years) with an ADHD diagnosis and an indication to start methylphenidate (MPH) treatment were recruited. Participants were randomized to PCT or care as usual (CAU) in a 1:1 ratio followed by a 7-week randomized controlled trial (T1) and 6-month, naturalistic, open-label follow-up (T2). Parents, teachers, and physicians rated ADHD symptoms, ADHD medication use, MPH dosing, and treatment satisfaction using questionnaires.

resultsA total of 100 children were enrolled and randomized to PCT (n = 49) or CAU (n = 51). In the PCT group, we found 8.2% placebo responders, 16.3% non-responders, and 65.3% responders to MPH. With PCT compared with CAU, a significantly larger number of children discontinued MPH (T1: 24.5 vs 5.9%, p = 0.009; T2: 41.7 vs 10.4%, p < 0.001) and refrained from using other pharmacological treatment (T1: 20.4 vs 3.9%, p = 0.013; T2: 20.83 vs 6.25%, p = 0.002). At both timepoints, there were no significant differences between the groups in the average dose of MPH, ADHD symptoms, or treatment satisfaction.

conclusionsPCT can be used to improve detection of children who do not benefit from MPH, and may therefore potentially reduce overtreatment of ADHD with MPH.

Indexed as

Attention Deficit Disorder with HyperactivityCentral Nervous System StimulantsMethylphenidateAdolescentChildChild, PreschoolDouble-Blind MethodFemaleHumansMaleTreatment OutcomeCentral Nervous System StimulantsMethylphenidate

Identifiers

PMID38280943
OpenAlexW4391275441

What OpenQuestion holds

Textmetadata
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.