Long-acting methylphenidate has an effect on aggressive behavior in children with attention-deficit/hyperactivity disorder

• Published in: Journal of child and adolescent psychopharmacology Vol. 17; no. 4; p. 421
• Main Authors: Sinzig, Judith, Döpfner, Manfred, Lehmkuhl, G, Uebel, H, Schmeck, K, Poustka, F, Gerber, W D, Günter, M, Knölker, U, Gehrke, M, Hässler, F, Resch, F, Brünger, M, Ose, C, Fischer, R
• Format: Journal Article
• Language: English
• Published: United States 01-08-2007
• Subjects: Adolescent; Aggression - drug effects; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - drug therapy; Central Nervous System Stimulants - administration & dosage; Central Nervous System Stimulants - therapeutic use; Child; Comorbidity; Conduct Disorder - complications; Conduct Disorder - drug therapy; Delayed-Action Preparations; Diagnostic and Statistical Manual of Mental Disorders; Double-Blind Method; Faculty; Female; Humans; Male; Methylphenidate - administration & dosage; Methylphenidate - therapeutic use; Parents; Schools
• ISSN: 1044-5463
• DOI: 10.1089/cap.2007.0011

Aggression is frequently observed in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the efficacy with regard to oppositional and aggressive behavior of a new long-acting methylphenidate preparation (Medikinet retard, MPH-MR), with equal portions of the immediate-release and the sustained-release active substance, and especially to look at correlations between either teacher or parent assessment of aggression and ADHD sub-symptomatology.
Eighty five children and adolescents (6-16 years) were investigated in a double-blind, randomized, clinical trial over 5 weeks under a treatment with MPH-MR using symptom checklists for ADHD, oppositional-defiant and conduct disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).
A total of 64.9% of the children showed oppositional defiant disorder/conduct disorder (ODD/CD) symptoms. A statistically significant effect was found in the group treated with MPH (verum-group). On the basis of Cohen's criteria, high effects were found for aggressive symptoms in school (d = 1.0), but not in the afternoon (d = 0.4). There were also lower effect sizes for more severe aggressive symptoms. We found characteristic correlations between ODD/CD symptoms and the ADHD subscale hyperactivity/impulsivity compared to the subscale inattention.
Long-acting MPH is effective in the treatment of oppositional-defiant and aggressive behavior, especially concerning milder symptoms. The expected correlation between impulsivity and aggressiveness could be confirmed.