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Findings from an 8-week, placebo-controlled trial indicate that immediate-release methylphenidate (MPH-IR) is safe and effective in controlling symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with chronic multiple tic disorder.
The investigators found that MPH-IR suppressed certain ADHD symptoms such as oppositional defiant disorder and peer aggression. There was no evidence of change in the overall severity of tic disorders, although teacher ratings indicated that MPH-IR decreased the severity and frequency of tics.
According to the lead author of the current study, Kenneth D. Gadow, Ph.D., and colleagues, physicians continue to receive mixed messages with regard to the appropriateness of MPH-IR use with tics. Advertisements and package inserts warn against the use of stimulants in treating children with ADHD who have a pre-existing tic disorder.
Some studies have shown mixed results regarding the efficacy of MPH-IR in reducing ADHD symptoms in children with tics. Additionally, clinician and parent reports have even indicated MPH-IR suppressed tics, while teacher reports indicated little or no improvement.
At the same time, a number of uncontrolled reports have continued to indicate that ADHD drugs induce tics in children with ADHD. For some, the stimulants are still considered second-line medications for children with ADHD and comorbid tic disorders, or else "share first-line status with medications generally not shown to be particularly effective for the management of core ADHD symptoms (e.g., Zinner, 2004)," write Gadow and colleagues.
In an earlier double-blind, placebo-controlled, …