Efficacy of methylphenidate hydrochloride prolonged-release tablets and atomoxetine on symptoms and executive function in children with attention deficit hyperactivity disorder

LI Yan; WEN Zhu; DENG Si-yu; JIANG Wen-qing; FAN Juan; DU Ya-song

doi:10.11852/zgetbjzz2022-0284

PDF(708 KB)

Chinese Journal of Child Health Care ›› 2022, Vol. 30 ›› Issue (12) : 1291-1296. DOI: 10.11852/zgetbjzz2022-0284

Efficacy of methylphenidate hydrochloride prolonged-release tablets and atomoxetine on symptoms and executive function in children with attention deficit hyperactivity disorder

LI Yan^*, WEN Zhu^*, DENG Si-yu, JIANG Wen-qing, FAN Juan, DU Ya-song

Author information +

History +

Abstract

Objective To compare the improvement of symptoms and executive function of children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate hydrochloride (MPH) prolonged-release tablets and atomoxetine (ATX), in order to provide more reference for clinical intervention. Methods From 2017 to 2019,children with ADHD who had not been medicated in the Pediatric and Juvenile Outpatient Clinic of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine were selected into the study, then 64 ADHD Children were divided into MPH group and ATX group according to medication treatment strategy. Changes in symptom scores and executive function indicators were assessed at baseline, at the end of 4, 8, and 24 weeks of medication. Swanson, Nolan, and Pelham Rating Scale-Ⅳ (SNAP-Ⅳ) and Conners Parents Symptom Questionnaire (PSQ) were used to evaluate symptoms. Executive function was evaluated by Stroop color-word test, Wisconsin card classification test and Digital Span test. Results Symptom scores and several core indicators of executive function improved significantly in both groups of ADHD children at the end of the 24th weekend (P<0.05). There were no significant differences in SNAP-Ⅳ scale scores, PSQ scores, Stroop test, as well as the scores of WCST and Digital Span between the two groups at baseline, at the end of 4th week, 8th week and 24th week (P>0.05). Conclusion Both MPH and ATX can continuously improve behavioral symptoms and executive function performance of ADHD children.

Key words

attention deficit hyperactivity disorder / behavioral symptoms / executive function / medication intervention

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LI Yan, WEN Zhu, DENG Si-yu, JIANG Wen-qing, FAN Juan, DU Ya-song. Efficacy of methylphenidate hydrochloride prolonged-release tablets and atomoxetine on symptoms and executive function in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Child Health Care. 2022, 30(12): 1291-1296 https://doi.org/10.11852/zgetbjzz2022-0284

References

[1] 杜亚松,曹阳,江文庆. 注意缺陷多动障碍儿童的执行功能[J]. 中国儿童保健杂志, 2019, 27(5):465-468,472.
[2] 王玉凤. 注意缺陷多动障碍[M]. 北京: 北京大学医学出版社, 2019.
[3] Coghill DR, Seth S, Pedroso S, et al. Effects of methylphenidate on cognitive functions in children and adolescents with attention-deficit/hyperactivity disorder:Evidence from a systematic review and a meta-analysis[J]. Biol Psychiat, 2014, 76(8):603-615.
[4] Rosenau PT, Openneer TJC, Matthijssen AM, et al. Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long-term use:A randomized, placebo-controlled discontinuation study[J]. J Child Psychol Psychiatry, 2021, 62(12):1444-1452.
[5] Ünal D, Mustafaoğlu Çiçek N, Çak T, et al. Comparative analysis of the WISC-Ⅳ in a clinical setting: ADHD vs. non-ADHD[J]. Arch Pediatr, 2021, 28(1):16-22.
[6] Hall CL, Guo B, Valentine AZ, et al. The validity of the SNAP-Ⅳ in children displaying ADHD symptoms[J]. Assessment, 2020, 27(6):1258-1271.
[7] Izzo VA, Donati MA, Primi C. Assessing ADHD through the multi-informant approach: The Contribution of the Conners′ 3 Scales[J]. J Atten Disord, 2019, 23(6):641-650.
[8] Periáñez JA, Lubrini G, García-Gutiérrez A, et al. Construct validity of the Stroop Color-Word Test: Influence of Speed of visual search, verbal fluency, working memory, cognitive flexibility, and conflict monitoring [J]. Arch Clin Neuropsychol, 2021, 36(1):99-111.
[9] Arán Filippetti V, Krumm GL, Raimondi W. Computerized versus manual versions of the Wisconsin Card Sorting Test: Implications with typically developing and ADHD children[J]. Appl Neuropsychol Child, 2020,9(3):230-245.
[10] Wells EL, Kofler MJ, Soto EF, et al. Assessing working memory in children with ADHD: Minor administration and scoring changes may improve digit span backward′s construct validity[J]. Res Dev Disabil, 2018, 72:166-178.
[11] Kofler MJ, Sarver DE, Harmon SL, et al. Working memory and organizational skills problems in ADHD [J]. J Child Psychol Psychiatry, 2018, 59(1):57-67.
[12] Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults:A systematic review and network meta-analysis. [J]. Lancet Psychiatry, 2018, 5(9):727-738.
[13] Taş Torun Y, Işik Taner Y, Güney E, et al. Osmotic Release Oral System-Methylphenidate Hydrochloride (OROS-MPH) versus atomoxetine on executive function improvement and clinical effectiveness in ADHD: A randomized controlled trial[J]. Appl Neuropsychol Child, 2020, 6:1-12.
[14] 赵滢, 杜亚松, 蒋良函, 等. 盐酸托莫西汀对注意缺陷多动障碍儿童行为特征的影响[J]. 临床精神医学杂志, 2011, 21(4):240-242.
[15] Huang YS, Yeh CB, Chen CH, et al. A randomized, double-blind, placebo-controlled, two-way crossover clinical trial of ORADUR-Methylphenidate for treating children and adolescents with attention-deficit/hyperactivity disorder[J]. J Child Adolesc Psychopharmacol, 2021,31(3):164-178.
[16] Brown TE,Holdnack J,Saylor K,et al. Effect of Atomoxetine on executive function impairments in adults with ADHD [J]. J Atten Disord, 2011, 15(2) :130-138.
[17] Griffiths KR, Leikauf JE, Tsang TW, et al. Response inhibition and emotional cognition improved by atomoxetine in children and adolescents with ADHD: The ACTION randomized controlled trial[J]. J Psychiatr Res, 2018, 102:57-64.
[18] Rubio Morell B, Hernández Expósito S. Differential long-term medication impact on executive function and delay aversion in ADHD[J]. Appl Neuropsychol Child, 2019, 8(2):140-157.
[19] Kratz O, Studer P, Baack J, et al. Differential effects of methylphenidate and atomoxetine on attentional processes in children with ADHD:An event-related potential study using the Attention Network Test[J]. Prog neuropsychopharmacol boilpsychiatry, 2012, 37(1):81-89.
[20] Ni HC,Shang CY,Gau SS, et al. A head-to-head randomized clinical trial of methylphenidate and atomoxetine treatment for executive function in adults with attention-deficit hyperactivity disorder [J]. Int J Neuropsychopharmacol, 2013, 16(9):1959-1973.
[21] Wu CS, Shang CY, Lin HY, et al. Differential treatment effects of Methylphenidate and Atomoxetine on executive functions in children with attention-deficit/hyperactivity disorder[J]. J Child Adolesc Psychopharmacol, 2021, 31(3):187-196.
[22] Kowalczyk OS, Cubillo AI, Smith A, et al. Methylphenidate and atomoxetine normalise fronto-parietal underactivation during sustained attention in ADHD adolescents[J]. Eur Neuropsychopharmacol, 2019, 29(10):1102-1116.