Predicting methylphenidate response in long-term survivors of childhood cancer: a randomized, double-blind, placebo-controlled, crossover trial

J Pediatr Psychol. 2010 Mar;35(2):144-55. doi: 10.1093/jpepsy/jsp044. Epub 2009 May 22.

Abstract

Objective: To investigate the methylphenidate (MPH) response rate among childhood survivors of acute lymphoblastic leukemia (ALL) and brain tumors (BTs) and to identify predictors of positive MPH response.

Methods: Cancer survivors (N = 106; BT = 51 and ALL = 55) identified as having attention deficits and learning problems participated in a 3-week, double-blind, crossover trial consisting of placebo, low-dose MPH (0.3 mg/kg), and moderate-dose MPH (0.6 mg/kg). Weekly teacher and parent reports on the Conners' Rating Scales were gathered.

Results: Following moderate MPH dose, 45.28% of the sample was classified as responders. Findings revealed that more problems endorsed prior to the medication trial on parent and teacher ratings were predictive of positive medication response (p < .05).

Conclusions: MPH significantly reduces attention problems in a subset of childhood cancer survivors. Parent and teacher ratings may assist in identifying children most likely to respond to MPH so prescribing may be optimally targeted.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention / drug effects*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / epidemiology
  • Child
  • Cognition / drug effects
  • Comorbidity
  • Cross-Over Studies
  • Dopamine Uptake Inhibitors / administration & dosage
  • Dopamine Uptake Inhibitors / therapeutic use*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Learning Disabilities / drug therapy*
  • Learning Disabilities / epidemiology
  • Learning Disabilities / psychology
  • Male
  • Methylphenidate / administration & dosage
  • Methylphenidate / therapeutic use*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology
  • Predictive Value of Tests
  • Psychological Tests
  • Severity of Illness Index
  • Survivors / psychology
  • Tennessee / epidemiology
  • Treatment Outcome

Substances

  • Dopamine Uptake Inhibitors
  • Methylphenidate