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First published on May 12, 2008
Journal of Child Neurology 2008, doi:10.1177/0883073808315412

Article

Methylphenidate in Children With Oppositional Defiant Disorder and Both Comorbid Chronic Multiple Tic Disorder and ADHD

Kenneth D. Gadow, PhD1*, Edith E. Nolan, PhD1, Jeffrey Sverd, MD2, Joyce Sprafkin, Ph.D1, and Jayne Schneider, PhD1

1 Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook
2 John T. Mather Memorial Hospital, Port Jefferson, New York

* To whom correspondence should be addressed. E-mail: kenneth.gadow{at}stonybrook.edu.


  Abstract
Our primary objective was to determine if immediate-release methylphenidate is an effective treatment for oppositional defiant disorder diagnosed from mother’s report in children with both chronic multiple tic disorder and attention-deficit hyperactivity disorder (ADHD). Children (n = 31) aged 6 to 12 years received placebo and 3 doses of methylphenidate twice daily for 2 weeks each under double-blind conditions and were assessed with ratings scales and laboratory measures. Results indicated significant improvement in both oppositional and ADHD behaviors with medication; however, the magnitude of treatment effect varied considerably as a function of disorder (ADHD > Oppositional behaviors), informant (teacher > mother), assessment instrument, and specific oppositional behavior (rebellious > disobeys rules). Drug response was comparable with that in children (n = 26) who did not have diagnosed oppositional defiant disorder, but comorbidity appeared to alter the perceived benefits for ADHD according to mother’s report. Methylphenidate is an effective short-term treatment for oppositional behavior in children with comorbid ADHD and chronic multiple tic disorder.


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