Ameliorating Attention Problems in Children With Sickle Cell Disease: A Pilot Study of Methylphenidate

• Published in: Journal of developmental and behavioral pediatrics Vol. 33; no. 3; pp. 244 - 251
• Main Authors: DALY, Brian, KRAL, Mary C, BROWN, Ronald T, ELKIN, David, MADAN-SWAIN, Avi, MITCHELL, Monica, CROSBY, Lori, DEMATTEO, David, LAROSA, Angela, JACKSON, Sherron
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-04-2012; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adolescent; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - drug therapy; Anemia, Sickle Cell - psychology; Anemias. Hemoglobinopathies; Attention - drug effects; Biological and medical sciences; Central Nervous System Stimulants - administration & dosage; Child; Children & youth; Clinical trials; Cognition - drug effects; Diseases of red blood cells; Double-Blind Method; Female; Hematologic and hematopoietic diseases; Humans; Male; Medical sciences; Memory; Methylphenidate - administration & dosage; Neuropharmacology; Pharmacology. Drug treatments; Pilot Projects; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Reaction Time - drug effects; Sickle cell disease; Stimulants; Treatment Outcome; Human; Hemoglobinopathy; Sickle cell anemia; CNS stimulant; Chronic disease; Psychotropic; pilot study; Hemopathy; Genetic disease; sickle cell disease; intervention outcome; Hemolytic anemia; Attentional disorder; chronic illness; Piperidine derivatives; Child; Methylphenidate
• ISSN: 0196-206X; 1536-7312
• DOI: 10.1097/DBP.0b013e31824ba1b5

This pilot study examined whether methylphenidate (MPH) was effective in enhancing cognitive performance and attention for children with sickle cell disease (SCD) with cerebrovascular complications who evidence attention problems.
In this multisite, pilot study, we evaluated 2 separate double-blind controlled clinical trials, including a laboratory trial of the short-term efficacy of MPH, with the second study a 3-week home/school crossover trial evaluating the efficacy of MPH. The laboratory trial included 14 participants between the age of 7 and 16 years. Assessments included measures of sustained attention, reaction time, executive functions, and verbal memory. The home/school trial included 20 participants. The outcome measures were parent and teacher ratings of attention. The first study compared MPH with placebo, while the second trial compared placebo, low-dose (LD) MPH, and moderate-dose MPH.
In the laboratory trial, significant effects were revealed for measures of memory and inhibitory control. Parent and teacher reports from the home/school trial indicate that moderate-dose MPH produced superior improvement in attention relative to the placebo and LD MPH.
Stimulant medication positively impacted select measures of memory and inhibitory control in some children with SCD. Attention, as rated by parent and teachers, was improved for a greater number of children and adolescents on higher doses of MPH relative to LD MPH and placebo. Stimulant medication may provide an effective intervention for some children with SCD and cerebrovascular complications who demonstrate attention problems.