Methylphenidate vs Dextroamphetamine vs Caffeine in Minimal Brain Dysfunction: Controlled Comparison by Placebo Washout Design With Bayes' Analysis
Abstract
Double-blind crossover comparison of methylphenidate hydrochloride, dextroamphetamine sulfate, and caffeine after placebo washout in 29 children with minimal brain dysfunction (MBD) showed on six ratings that methylphenidate and dextroamphetamine were significantly (P less than .05 to P less than .001) better than placebo and caffeine, but not significantly (P less than .05) different from each other. Placebo, caffeine, and ratings before drug did not differ significantly. Of 26 drug responders, 12 responded best to dextroamphetamine, ten to methylphenidate, and one to caffeine. The latter child showed no improvement at all with either prescription stimulant. Methylphenidate and dextroamphetamine were each efficacious for six children who did not respond to the other stimulant. All three drugs showed significant (P less than .05) weight loss and cardiovascular side effects, the latter possibly spurious. Dextroamphetamine showed a significant (P less than .05) decrease from placebo in "tummyaches."
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In two separate crossover studies comparing the efficacy of methylphenidate and dextroamphetamine, most children with ADHD who did not respond to one stimulant responded to the other.
“In 2 separate crossover studies [31,32] comparing the efficacy of MPH and dextroamphetamine, most children with ADHD who did not respond to 1 stimulant responded to the other.”
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- Authors
- Arnold, L. E.
- Corresponding author
- Arnold, L. Eugene
- ORCID
- Arnold, L. Eugene
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1978-04-01
- Volume
- 35
- Issue
- 4
- Pages
- 463
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2142349212
- Cited by
- 104
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2021: 1 · 2018: 5 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- methylphenidate, d-amphetamine, caffeine, minimal brain dysfunction, attention deficit hyperactivity disorder, stimulants, children, drug efficacy, placebo response, weight loss, cardiovascular side effects
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Caffeine, Child, Child, Preschool, Clinical Trials as Topic, Dextroamphetamine, Dose-Response Relationship, Drug, Double-Blind Method, Factor Analysis, Statistical, Female, Humans, Hyperkinesis, Male, Methylphenidate
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