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

Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook, kenneth.gadow{at}stonybrook.edu

Edith E. Nolan, PhD

Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook

Jeffrey Sverd, MD

John T. Mather Memorial Hospital, Port Jefferson, New York

Joyce Sprafkin, PhD

Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook

Jayne Schneider, PhD

Department of Psychiatry and Behavioral Science, State University of New York, Stony Brook

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.

Key Words: oppositional defiant disorder • attention-deficit hyperactivity disorder • chronic multiple tic disorder • Tourette syndrome • methylphenidate • aggression

This version was published on September 1, 2008

Journal of Child Neurology, Vol. 23, No. 9, 981-990 (2008)
DOI: 10.1177/0883073808315412


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