• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.2
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• pp.49-56
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• 2012

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.1
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• pp.10-16
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• 2021

Objectives: The aim of this study was to compare the compliance, efficacy, and satisfaction associated with methylphenidate and atomoxetine for treating attention-deficit/hyperactivity disorder (ADHD). Methods: The subjects were 44 patients who met the Diagnostic and Statistical Manual of Mental Disorder-5 diagnostic criteria for ADHD and were treated with methylphenidate or atomoxetine. The methylphenidate formulations included immediate release (IR), extended release (ER), and osmotic-controlled release oral delivery system (OROS). Patients and parents reported the average number of days per week the medication was taken. Efficacy was assessed using the ADHD Rating Scale. Satisfaction with medication scale (SAMS)-parent report form and SAMS-self-report form were used to evaluate parents' and patients' satisfaction, respectively. Results: Patients and parents were more satisfied with methylphenidate than with atomoxetine. There were no significant differences in the compliance with and efficacy of methylphenidate and atomoxetine. Compliance with methylphenidate IR and ER was markedly lower than that with OROS methylphenidate or atomoxetine. Conclusion: Methylphenidate OROS formulation can be considered a suitable option given its high rates of compliance, satisfaction, and efficacy.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.235-244
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• 2003

Purpose: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. Materials and Method: Nine drug-naive children with ADHD and seven normal children were included in the study. We peformed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of soecific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate(0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results: Children with ADHD had a significantly greater specificinonspecific DAT binding ratio of the basal ganglia comparing to normal children(Right : z = 2.057, p = 0.041 : Left : z : 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specificinonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t = 3.239, p = 0.018 ; Left : t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.221-226
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• 2005

The incidence of the Attention Deficit Hyperactivity Disorder secondary to the traumatic brain injury, such as traffic accidents, is increasing;the variety of the treatment modality is also increasing. This case was studied to see if OROS Methylphenidate(Concerta), which is one of the most commonly used medication in Attention Deficit Hyperactivity Disorder patients, not only improves the patient's attention, but also their impulsivity, hyperactivity and aggression. According to the case result, the medication showed an improvement of the impulsivity, aggression, and attention in the secondary Attention Deficit Hyperactivity Disorder patients after the traumatic brain injury.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.1
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• pp.64-71
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• 2016

Objectives: The objective of this study was to examine the effects of osmotic-controlled release oral delivery system methylphenidate on changes in regional cerebral blood flow (rCBF) in children with attention-deficit hyperactivity disorder (ADHD) using single photon emission computed tomography (SPECT). Methods: A total of 26 children with ADHD (21 boys, mean age: $9.2{\pm}2.05$ years old) were recruited. Each ADHD participant was examined for changes in rCBF using technetium-99m-hexamethylpropylene amine oxime brain SPECT before and after 8 weeks methylphenidate medication. Brain SPECT images of pediatric normal controls were selected retrospectively. SPECT images of ADHD children taken before medication were compared with those of pediatric normal controls and those taken after medication using statistical parametric mapping analysis on a voxel-wise basis. Results: Before methylphenidate medication, significantly decreased rCBF in the cerebellum and increased rCBF in the right precuneus, left anterior cingulate, right postcentral gyrus, right inferior parietal lobule and right precentral gyrus were observed in ADHD children compared to pediatric normal controls (p-value<.0005, uncorrected). After medication, we observed significant hypoperfusion in the left thalamus and left cerebellum compared to pediatric normal controls (p-value<.0005, uncorrected). In the comparison between before medication and after medication, there was significant hyperperfusion in the superior frontal gyrus and middle frontal gyrus and significant hypoperfusion in the right insula, right caudate, right middle frontal gyrus, left subcallosal gyrus, left claustrum, and left superior temporal gyrus after methylphenidate medication (p-value<.0005, uncorrected). Conclusion: This study supports dysfunctions of fronto-striatal structures and cerebellum in ADHD. We suggest that methylphenidate may have some effects on the frontal lobe, parietal lobe, and cerebellum in children with ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.2
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• pp.125-132
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• 2023

Objectives: This study investigated the relationship between suicidal behavior and the use of methylphenidate (MPH) or atomoxetine (ATX) in patients with attention deficit hyperactivity disorder (ADHD). Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to conduct a meta-analysis. The Physiotherapy Evidence Database scale was used to score the quality of the studies. Results: Nine studies were included in this quantitative analysis. The analysis included 602864 patients with ADHD (521125 and 81739 patients were taking methylphenidate [MPH group] and atomoxetine [ATX group], respectively) and 19230 healthy controls. The overall estimates were in the order of the control, MPH, and ATX groups; however, no statistically significant between-group difference was observed in the incidence of events (p=0.553 for control vs. MPH; p=1.000 for control vs. ATX; p=1.000 for MPH vs. ATX). Conclusion: The rate of suicidal behavior was higher in the ADHD groups treated with MPH and ATX than in the control group. However, no statistically significant difference was observed between the ADHD groups treated with MPH and ATX, and the control group. Therefore, MPH and ATX did not increase suicidal behavior.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.157-163
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• 2013

Objectives : Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. Methods : The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. Results : After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. Conclusion : Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.

• Clinical and Experimental Pediatrics
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• v.62 no.9
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• pp.360-366
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• 2019

Background: Attention deficit-hyperactivity disorder (ADHD) is one of the most common chronic behavioral disorders in school-aged children. Purpose: This study aimed to evaluate the effect of omega-3 supplementation as an alternative therapy for ADHD, which can be caused by vitamin and mineral deficiencies. Methods: This was a double-blinded clinical trial study. Sixty-six children with ADHD (aged 6-12 years) referred to our child and adolescent psychiatric educational and therapeutic clinic were selected based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Instruments including the Parent ADHD Rating Scale were used to assess ADHD at 0, 2, 4, and 8 weeks during the study. Results: The results showed no statistically significant difference between the methylphenidate with omega-3 group and methylphenidate with placebo group based on the Parents ADHD Rating Scale between week 0 ($P{\geq}0.96$) and week 8 ($P{\geq}0.75$). There were no significant intergroup differences between the Inattention ($P{\geq}0.48$) and hyperactivity/impulsivity ($P{\geq}0.80$) subscale scores on the Parents ADHD Rating Scale. The most common drug complications in the methylphenidate with placebo and methylphenidate with omega-3 groups were anorexia (27 [54%] vs. 41 [60.29%], respectively) and diarrhea (10 [20%] vs. 8 [11.76%], respectively), but the differences were not statistically significant (P>0.05). Conclusion: Our results demonstrate that a specific dose of omega-3 for 8 weeks had no effect on ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.218-226
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• 1998

This study aims at investigating the effects of psychostimulant on functional cerebral localization during the attentional tasks in ADHD. Inclusional subjects were 13 boy between 6-12 years old who met the DSM-IV criteria for ADHD. In each patient, there was a drugfree period(without methyphenidate) and a drug-loaded period(with oral methylphenidate administration), and within each period there was a resting state and a stimulated state with TOVA. Comparisons were made by measuring the amplitudes of four bands(${\alpha}$, ${\beta}$, ${\delta}$, ${\theta}$) of quantitative EEG to see if there were any differences between the drug-free period(resting and stimulated) and the drug-loaded period(resting and stimulated). In the resting state, there was no difference between the drug-free and drug-loaded periods. In the stimulated state with TOVA, the presence of methylphenidate induced significant changes in the theta to beta ratio(${\theta}/{\beta}$) in the right frontal, right parieto-occipital, and left temporal-parietal areas in contrast to the drugf-ree period. These data suggest that methylphenidate shows electrophysiological influences on cerebral topographical activities during the attentional tasks in ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.3 no.1
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• pp.26-45
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• 1992

This study presents the behavioral and cognitive changes by administration of methylphenidate(MPH) and imipramine(IMI) for the treatment of attention-deficit hyperactivity disorder(ADHD) in $5_{1/2}{\sim}12$ years old children referred to child psychiatric clinics. Behavioral changes are assessed with parent's and teacher's ratings. Drug effects on attention. short-term memory, and impulsivity are evaluated with psychological tests in laboratory. The changes were assessed twice in a 8-week periods. The data were analyzed seperately for 15 subjects each drug using repeated measured analysis of variance(ANOVA). The findings indicates that behavioral and cognitive impairments are improved by both drugs, but impulsivity is not. And MPH is superior to IMI on the improvement of attentional problem ; especially the findings indicates important differences between simple task and complex. perceptual-search task. These data confirm the effectiveness of MPH for treatment of ADHD, also raise questions regarding assessment method of attention and impulsivity as fell as importance of impulsivity in ADHD.