Comparison of Stimdate with Ritalin in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Double-Blind, Randomized Clinical Trial

Article excerpt

Objectives: The aim of this randomized clinical trial was to assess the efficacy of stimdate compared to ritalin in the treatment of children with attention deficit hyperactivity disorder (ADHD).

Method: Sixty four subjects (45 boys and 15 girls) aged 5-13 who were diagnosed with ADHD based on (DSM-IV-TR) criteria were selected for this study. The subjects were randomly assigned to two groups: one group with 30 subjects received stimdate and the other group of 30 subjects received ritalin for 6 weeks. Treatment outcomes were assessed using the Attention Deficit Hyperactivity Rating Scale administered at baseline and on weeks 2, 4 and 6 following the treatment. A two-way repeated measures analysis of variance (time- treatment interaction) was used.

Results: There were no significant differences between sex, age, weight, and ethnicity of the participants in the 2 groups. Both groups showed a significant improvement during the 6 weeks of the treatment period, and this improvement was due to the parents' ADHD Rating Scale during the treatment.

Conclusion: Based on the results of this study, no significant difference was observed between the two medications, and it seems both drugs behave in a similar way. In addition, stimdate appears to be effective and well tolerated for ADHD in children and adolescents in Iran.

Keywords: Adolescents, Attention deficit disorder with hyperactivity, Children, Generic drugs, Methylphenidate

Iran J Psychiatry 2008; 4:31-35

Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. The incidence of ADHD is 5-10% in children and the symptoms are known to persist into adulthood in 10-60% of the cases (1). The etiology of ADHD is not understood, yet potent drugs are being employed for its medical management while safe and effective alternatives are being neglected. Neurochemical studies suggest alterations in catecholaminergic-mainly dopaminergic and noradrenergic-transmitter functions markedly contribute to the symptoms of ADHD. The ADHD symptoms are significantly ameliorated by agents that specifically influence these neurotransmitter systems; animal studies implicate those areas of the brain where these neurotransmitters are most dominant.Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. The incidence of ADHD is 5-10% in children and the symptoms are known to persist into adulthood in 10-60% of the cases (1). The etiology of ADHD is not understood, yet potent drugs are being employed for its medical management while safe and effective alternatives are being neglected. Neurochemical studies suggest alterations in catecholaminergic-mainly dopaminergic and noradrenergic-transmitter functions markedly contribute to the symptoms of ADHD. The ADHD symptoms are significantly ameliorated by agents that specifically influence these neurotransmitter systems; animal studies implicate those areas of the brain where these neurotransmitters are most dominant.

In conjunction with psychosocial interventions such as parent training, contingency management, and social skills training, stimulant pharmacotherapy has been used for the treatment of ADHD for many decades in (2, 3).

Although stimulants are highly effective in controlling the symptoms of ADHD, some children will not respond to, or do not tolerate them. Thus, the desire for safe and effective non-stimulant medications has risen during the past several years (4-10).

In Iran, ADHD signs and symptoms are regarded as being ordinary in some families, especially when boys are concerned. Furthermore, pharmacotherapy for ADHD children is regarded unfavorably by parents (6). Greenhill study showed that release methylphenidate (MPH), administered once daily in the morning is effective and safe in controlling ADHD symptoms throughout the day (11). Children suffering from ADHD respond differentially to treatment with ritalin (12). …

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