Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD
Objectives: Methylphenidate (MPH) is highly effective in controlling the symptoms of attention-deficit/hyperactivity disorder (ADHD), but some children with ADHD either do not respond to, or do not tolerate, treatment. Dextromethorphan (DM) is a neuroprotective agent which has been used in the treat...
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| Format: | Article |
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00437/full |
| _version_ | 1811259887934504960 |
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| author | Wei-Chen Chuang Wei-Chen Chuang Chin-Bin Yeh Sheng-Chiang Wang Sheng-Chiang Wang Pei-Yin Pan Jia-Fwu Shyu Jia-Fwu Shyu Yia-Ping Liu Yia-Ping Liu Susan Shur-Fen Gau Ru-Band Lu Ru-Band Lu Ru-Band Lu |
| author_facet | Wei-Chen Chuang Wei-Chen Chuang Chin-Bin Yeh Sheng-Chiang Wang Sheng-Chiang Wang Pei-Yin Pan Jia-Fwu Shyu Jia-Fwu Shyu Yia-Ping Liu Yia-Ping Liu Susan Shur-Fen Gau Ru-Band Lu Ru-Band Lu Ru-Band Lu |
| author_sort | Wei-Chen Chuang |
| collection | DOAJ |
| description | Objectives: Methylphenidate (MPH) is highly effective in controlling the symptoms of attention-deficit/hyperactivity disorder (ADHD), but some children with ADHD either do not respond to, or do not tolerate, treatment. Dextromethorphan (DM) is a neuroprotective agent which has been used in the treatment of neuropsychiatric disorders. This clinical trial had examined the effect of DM on the use of MPH in the children with ADHD.Methods: This randomized double-blind clinical trial had evaluated 44 male outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The study subjects were randomly assigned into one of the two groups: receiving MPH alone (15–60 mg per day) or MPH plus DM (30–60 mg per day) for 8 weeks. Assessments, comprising the Chinese version of the Child Behavior Checklist (CBCL-C) scale and the Swanson, Nolan and Pelham Questionnaire (SNAP)-IV rating tests conducted by parents and the serum cytokines measured by microarray and enzyme-linked immunosorband assay (ELISA), were compared between groups at baseline and at 8 weeks after the medication was started.Results: There were a significant decrease at the mean scores of both CBCL-C and SNAP-IV scales after 8 weeks of treatment, but no significant differences between MPH and MPH+DM groups. Compared with the MPH-only group, the mean scores of some psychometric parameters reported on the CBCL-C and SNAP-IV scales regarding time effects as well as the attention problems on the CBCL-C scale regarding group effect were significantly higher in the DM+MPH group. Although there were no significant differences in the levels of various serum cytokines between groups, the subjects in the DM-MPH group had relatively fewer and lower levels of adverse effects. Significant interactions were found between the withdrawn/depression item reported on the CBCL-C scale and tumor necrosis factor α (ခTNF-α) (p = 0.027), as well as between thought problems item on the CBCL-C and TNF-α (p = 0.028) in subjects who had received DM+MPH treatment.Conclusion: Following the trial, DM+MPH was not superior to MPH alone for the treatment of children with ADHD, yet DM may potentially have negative effects on ADHD symptoms when combined with MPH.Clinical Trial Registration: Clinicaltrials.gov, trial number: NCT01787136. |
| first_indexed | 2024-04-12T18:38:29Z |
| format | Article |
| id | doaj.art-1c2b26325253472e85846be14b879886 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-12T18:38:29Z |
| publishDate | 2019-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-1c2b26325253472e85846be14b8798862022-12-22T03:20:51ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-06-011010.3389/fpsyt.2019.00437436624Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHDWei-Chen Chuang0Wei-Chen Chuang1Chin-Bin Yeh2Sheng-Chiang Wang3Sheng-Chiang Wang4Pei-Yin Pan5Jia-Fwu Shyu6Jia-Fwu Shyu7Yia-Ping Liu8Yia-Ping Liu9Susan Shur-Fen Gau10Ru-Band Lu11Ru-Band Lu12Ru-Band Lu13Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Biology & Anatomy, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Physiology, National Defense Medical Center, Taipei, TaiwanDepartment of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanInstitute of Behavioral Medicine, College of Medicine and Hospital, National Cheng Kung University, Tainan, TaiwanAddiction Research Center, National Cheng Kung University, Tainan, TaiwanCenter for Neuropsychiatric Research, National Health Research Institutes, Miaoli, TaiwanObjectives: Methylphenidate (MPH) is highly effective in controlling the symptoms of attention-deficit/hyperactivity disorder (ADHD), but some children with ADHD either do not respond to, or do not tolerate, treatment. Dextromethorphan (DM) is a neuroprotective agent which has been used in the treatment of neuropsychiatric disorders. This clinical trial had examined the effect of DM on the use of MPH in the children with ADHD.Methods: This randomized double-blind clinical trial had evaluated 44 male outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The study subjects were randomly assigned into one of the two groups: receiving MPH alone (15–60 mg per day) or MPH plus DM (30–60 mg per day) for 8 weeks. Assessments, comprising the Chinese version of the Child Behavior Checklist (CBCL-C) scale and the Swanson, Nolan and Pelham Questionnaire (SNAP)-IV rating tests conducted by parents and the serum cytokines measured by microarray and enzyme-linked immunosorband assay (ELISA), were compared between groups at baseline and at 8 weeks after the medication was started.Results: There were a significant decrease at the mean scores of both CBCL-C and SNAP-IV scales after 8 weeks of treatment, but no significant differences between MPH and MPH+DM groups. Compared with the MPH-only group, the mean scores of some psychometric parameters reported on the CBCL-C and SNAP-IV scales regarding time effects as well as the attention problems on the CBCL-C scale regarding group effect were significantly higher in the DM+MPH group. Although there were no significant differences in the levels of various serum cytokines between groups, the subjects in the DM-MPH group had relatively fewer and lower levels of adverse effects. Significant interactions were found between the withdrawn/depression item reported on the CBCL-C scale and tumor necrosis factor α (ခTNF-α) (p = 0.027), as well as between thought problems item on the CBCL-C and TNF-α (p = 0.028) in subjects who had received DM+MPH treatment.Conclusion: Following the trial, DM+MPH was not superior to MPH alone for the treatment of children with ADHD, yet DM may potentially have negative effects on ADHD symptoms when combined with MPH.Clinical Trial Registration: Clinicaltrials.gov, trial number: NCT01787136.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00437/fullADHDchildrenadded-on therapymethylphenidatedextromethorphancytokines |
| spellingShingle | Wei-Chen Chuang Wei-Chen Chuang Chin-Bin Yeh Sheng-Chiang Wang Sheng-Chiang Wang Pei-Yin Pan Jia-Fwu Shyu Jia-Fwu Shyu Yia-Ping Liu Yia-Ping Liu Susan Shur-Fen Gau Ru-Band Lu Ru-Band Lu Ru-Band Lu Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD Frontiers in Psychiatry ADHD children added-on therapy methylphenidate dextromethorphan cytokines |
| title | Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD |
| title_full | Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD |
| title_fullStr | Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD |
| title_full_unstemmed | Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD |
| title_short | Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD |
| title_sort | potential negative effects of dextromethorphan as an add on therapy to methylphenidate in children with adhd |
| topic | ADHD children added-on therapy methylphenidate dextromethorphan cytokines |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00437/full |
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