The Open-Label Treatment of Attention-Deficit/Hyperactivity Disorder in 4-and 5-Year-Old Children with Beaded Methylphenidate

Objective: The aim of this study was to assess the effectiveness and tolerability of a long-acting methylphenidate (MPH) formulation, beaded MPH (B-MPH), for treatment of attention-deficit/hyperactivity disorder (ADHD) in 4- and 5-year-old children. Method: Eleven children (9 boys and 2 girls) with ADHD received 4 weeks of B-MPH treatment in a single-site, open-label pilot study. Medication dosing was flexible, with titration to a maximum of 30 mg/day. A brief education session on behavior management was offered to parents at each treatment visit. Results: Subjects experienced a mean decrease of 1.09 (standard deviation [SD] = 0.73, p < 0.01) on the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) ADHD composite score to an end point of 1.18 (SD = 0.64). Subjects demonstrated mean decreases in scores of inattention of 1.01 (SD = 0.85, p < 0.01) and in hyperactivity/impulsivity of 1.17 (SD = 0.74, p < 0.01), with end point scores of 1.10 (SD = 0.61) and 1.26 (SD = 0.77), respectively. The Clinical Global Impressions-Severity (CGI-S) scale showed a statistically significant improvement from a baseline mean of 5 to the final visit mean of 3.36 (p < 0.01). At the final visit, the mean daily B-MPH dose was 17.73 mg. Subjects did not experience any statistically significant changes in weight, blood pressure, or pulse during the study. The most common adverse event was decreased appetite. Conclusion: B-MPH was safe and effective for the treatment of ADHD in the 4- and 5-year-olds participating in this study.